MEDICARE: PAL-MED, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	333600000X	Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457304461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAL-MED, LLC

Provider Business Mailing Address
First Line	:	555 E NORTH LN STE 5075
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2490
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	454 BERRYHILL RD STE B
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-6447
Country	:	US
Telephone Number	:	803-791-9013
Fax Number	:	803-791-9019

Authorized Official
Title or Position	:	CCO
Name	:	WENDY RUSSALESI
Credential	:
Telephone Number	:	484-246-9499

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	10/15/2025

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Directions to “PAL-MED, LLC ” Practice Location

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