Healthcare Provider Details

I. General information

NPI: 1790690741
Provider Name (Legal Business Name): PALMETTO SENIOR CARE AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 ELMWOOD AVE
COLUMBIA SC
29201-2107
US

IV. Provider business mailing address

1303 ELMWOOD AVE
COLUMBIA SC
29201-2107
US

V. Phone/Fax

Practice location:
  • Phone: 803-467-4770
  • Fax: 803-764-0001
Mailing address:
  • Phone: 803-467-4770
  • Fax: 803-764-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. CHARITY ANITA STEWART
Title or Position: OWNER
Credential:
Phone: 803-467-4770