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NPI Code Detail

MEDICARE: PALMETTO HEALTH

MEDICARE: PALMETTO HEALTH
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
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871538397
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALMETTO HEALTH
Provider Business Mailing Address
First Line : PO BOX 402145
Second Line :
City : ATLANTA
State : GA
Zip : 30384-2145
Country : US
Telephone Number : 803-296-7313
Fax Number : 803-296-7330
Provider Business Practice Location Address
First Line : 1316 N LAKE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-7653
Country : US
Telephone Number : 803-296-7304
Fax Number : 803-296-7329
Authorized Official
Title or Position : DIRECTOR OF BUSINESS DEV., FINANCE
Name : DARRELL C COVEN
Credential :
Telephone Number : 803-296-7301
Provider Enumeration Date : 06/18/2006
Last Update Date : 12/27/2007

Similar Medicare Providers

1851388680 — DR. WILLIAM H HARMAN M.D.
Practice Location Address:
1316 N LAKE DR
LEXINGTON, SC
29072-7653
Practice Phone: 803-358-1191
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1619953015 — TERESA JONES OLSON MD
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1033181276 — DENNIS A COHEN MD
Practice Location Address:
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Practice Phone: 803-808-5050
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1124082805 — MARY E DANNELLY APN
Practice Location Address:
1316 N LAKE DR
LEXINGTON, SC
29072-7653
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1932124005 — DR. SCARLET R TAYLOR M.D.
Practice Location Address:
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LEXINGTON, SC
29072-7653
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1609951953 — MRS. LAURA L. TRUESDALE LISW-CP
Practice Location Address:
1316 N LAKE DR , ADOLESCENT RECOVERY CENTER
LEXINGTON, SC
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Practice Phone: 803-951-1940
Practice Fax: 803-951-1963

Directions to “PALMETTO HEALTH ” Practice Location

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