Healthcare Provider Details

I. General information

NPI: 1437185626
Provider Name (Legal Business Name): PALMETTO HOME MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 BROOKSIDE PKWY
LEXINGTON SC
29072-4234
US

IV. Provider business mailing address

138 BROOKSIDE PKWY
LEXINGTON SC
29072-4234
US

V. Phone/Fax

Practice location:
  • Phone: 803-796-7840
  • Fax: 803-796-7846
Mailing address:
  • Phone: 803-429-9310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number032345445
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MARIA VIGGIANO DENT
Title or Position: INSURANCE MANAGER
Credential:
Phone: 803-796-7840