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General NPI Number Information
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NPI Number | 1265462659
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Entity Type | Organization
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Legal Business Name | PALMETTO INFUSION SERVICES LLC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 3105 SUNSET BLVD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-3425
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Country | US
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Telephone | 800-809-1265
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Fax | 803-772-7782
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Provider Business Mailing Address
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Address Line | PO BOX 538476
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City | ATLANTA
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State | GA
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Zip | 30353-8476
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Country | US
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Telephone | 803-227-5447
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT REIMBURSEMENT
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Name | CONNIE C HARTLEY
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Credential |
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Telephone | 803-227-5447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 11512
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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