Healthcare Provider Details

I. General information

NPI: 1487417242
Provider Name (Legal Business Name): PACE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 ASHLEY RIVER RD STE B
CHARLESTON SC
29407-5384
US

IV. Provider business mailing address

820 FESSLERS PKWY STE 315
NASHVILLE TN
37210-2938
US

V. Phone/Fax

Practice location:
  • Phone: 843-300-3593
  • Fax: 843-747-3055
Mailing address:
  • Phone: 615-214-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: THEODORE MACDONALD
Title or Position: CEO
Credential:
Phone: 615-214-3777