Healthcare Provider Details

I. General information

NPI: 1477725463
Provider Name (Legal Business Name): PALMETTO HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 MCGEE ST
BAMBERG SC
29003-1338
US

IV. Provider business mailing address

PO BOX 7275
COLUMBIA SC
29202-7275
US

V. Phone/Fax

Practice location:
  • Phone: 803-245-0390
  • Fax: 803-245-0083
Mailing address:
  • Phone: 803-296-3164
  • Fax: 803-296-3319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number056
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number056
License Number StateSC

VIII. Authorized Official

Name: MR. JAMES M BRIDGES
Title or Position: COO
Credential:
Phone: 803-296-5678