Healthcare Provider Details

I. General information

NPI: 1902829500
Provider Name (Legal Business Name): PALMETTO SEATING AND MOBILITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 TILLOTSON RD.
ANDERSON SC
29621
US

IV. Provider business mailing address

780 TILLOTSON RD.
ANDERSON SC
29621
US

V. Phone/Fax

Practice location:
  • Phone: 864-296-6911
  • Fax: 864-296-6910
Mailing address:
  • Phone: 864-296-6911
  • Fax: 864-296-6910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number004294301
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number004294301
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number004294301
License Number StateSC

VIII. Authorized Official

Name: MARK MITCHELL
Title or Position: OWNER
Credential:
Phone: 864-296-6911