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General NPI Number Information
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NPI Number | 1861632523
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Entity Type | Organization
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Legal Business Name | PALMETTO SLEEP LAB LLC
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 1087 REDI MIX RD SUITE 4
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City | LITTLE RIVER
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State | SC
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Zip | 29566-7132
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Country | US
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Telephone | 843-390-5122
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Fax | 843-390-5133
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Provider Business Mailing Address
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Address Line | P O BOX 1226
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City | MYRTLE BEACH
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State | SC
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Zip | 29588
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Country | US
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Telephone | 843-390-5122
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Fax | 843-390-5133
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Authorized Official
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Title or Position | OWNER
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Name | MILTON CAPELL
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Credential |
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Telephone | 843-444-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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