Healthcare Provider Details

I. General information

NPI: 1811168974
Provider Name (Legal Business Name): PALMETTO HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MEDICAL PARK
COLUMBIA SC
29203
US

IV. Provider business mailing address

PO BOX 402150
ATLANTA GA
30384-2150
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-3280
  • Fax: 803-434-3280
Mailing address:
  • Phone: 803-434-3280
  • Fax: 803-434-3280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. DARRELL C COVEN
Title or Position: DIRECTOR - BUSINESS DEV/FINANCE
Credential:
Phone: 803-296-7301