Healthcare Provider Details

I. General information

NPI: 1487576393
Provider Name (Legal Business Name): PALMETTO BIRTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 ASHEWOOD COMMONS DR
COLUMBIA SC
29209-2727
US

IV. Provider business mailing address

189 ASHEWOOD COMMONS DR
COLUMBIA SC
29209-2727
US

V. Phone/Fax

Practice location:
  • Phone: 839-224-3075
  • Fax: 803-973-6242
Mailing address:
  • Phone: 839-224-3075
  • Fax: 803-973-6242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: CANDACE JONES
Title or Position: MIDWIFE
Credential: CPM, LM
Phone: 839-224-3075