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General NPI Number Information
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NPI Number | 1003351859
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Entity Type | Organization
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Legal Business Name | PALMETTO HEALTH
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 808 KAWANA RD
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City | COLUMBIA
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State | SC
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Zip | 29205-2033
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Country | US
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Telephone | 803-730-1208
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Fax |
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Provider Business Mailing Address
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Address Line | 808 KAWANA RD
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City | COLUMBIA
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State | SC
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Zip | 29205-2033
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Country | US
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Telephone | 803-730-1208
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR/ CRNA
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Name | CATHERINE GUTSHALL
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Credential |
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Telephone | 803-429-2403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 201173
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License Number State | SC
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