MEDICARE: READING RAILROAD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	3006	SC

General Provider Information

NPI Number	:	1780198812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	READING RAILROAD, LLC

Provider Business Mailing Address
First Line	:	1358 MCCUTCHEON RD
Second Line	:
City	:	LAKE CITY
State	:	SC
Zip	:	29560-5620
Country	:	US
Telephone Number	:	843-409-2585
Fax Number	:

Provider Business Practice Location Address
First Line	:	1358 MCCUTCHEON RD
Second Line	:
City	:	LAKE CITY
State	:	SC
Zip	:	29560-5620
Country	:	US
Telephone Number	:	843-409-2585
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH LANGUAGE PATHOLOGIST
Name	:	SUSAN M PALMER
Credential	:	MSP, CCC/SLP
Telephone Number	:	843-409-2585

Provider Enumeration Date	:	11/28/2017
Last Update Date	:	11/28/2017

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