MEDICARE: PALMETTO SPINE AND PAIN CARE CONSULTANTS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1871987990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMETTO SPINE AND PAIN CARE CONSULTANTS, LLC

Provider Business Mailing Address
First Line	:	4736 HIGHWAY 17 BYP S
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-5616
Country	:	US
Telephone Number	:	843-213-2039
Fax Number	:	843-293-2454

Provider Business Practice Location Address
First Line	:	4736 HIGHWAY 17 BYP S
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-5616
Country	:	US
Telephone Number	:	843-213-2039
Fax Number	:	843-293-2454

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN E. BOATWRIGHT
Credential	:	MD
Telephone Number	:	843-213-2039

Provider Enumeration Date	:	03/26/2015
Last Update Date	:	05/07/2026

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