Healthcare Provider Details

I. General information

NPI: 1700354164
Provider Name (Legal Business Name): PALMETTO PRIMARY CARE PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ELMS CENTER RD STE B
NORTH CHARLESTON SC
29406-9844
US

IV. Provider business mailing address

PO BOX 530062
ATLANTA GA
30353-0062
US

V. Phone/Fax

Practice location:
  • Phone: 843-572-7727
  • Fax: 843-569-5899
Mailing address:
  • Phone: 843-695-6071
  • Fax: 843-569-5879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SCOTT TURNER
Title or Position: CFO
Credential:
Phone: 843-695-6071