Healthcare Provider Details

I. General information

NPI: 1457304461
Provider Name (Legal Business Name): PAL-MED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 BERRYHILL RD STE B
COLUMBIA SC
29210-6447
US

IV. Provider business mailing address

555 E NORTH LN STE 5075
CONSHOHOCKEN PA
19428-2490
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-9013
  • Fax: 803-791-9019
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: WENDY RUSSALESI
Title or Position: CCO
Credential:
Phone: 484-246-9499