MEDICARE: PALMETTO SLEEP LAB 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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1912564790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALMETTO SLEEP LAB LLC

Provider Business Mailing Address
First Line	:	PO BOX 1226
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29578-1226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2724 W PALMETTO ST STE 12
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29501-4909
Country	:	US
Telephone Number	:	843-407-6700
Fax Number	:	843-407-7999

Authorized Official
Title or Position	:	OWNER
Name	:	JERRY MILTON CAPELL
Credential	:
Telephone Number	:	843-444-0880

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	05/28/2019

Similar Medicare Providers

1548936404 — LAVANDA AYANA SMOOT MARTIN FNP-BC
Practice Location Address:

2724 W PALMETTO ST STE 5
FLORENCE, SC
29501-4909

Practice Phone: 843-799-2649
Practice Fax: 843-799-4224

1952340390 — CAROLINA SLEEP DIAGNOSTICS, INC
Practice Location Address:

2724 W PALMETTO ST , SUITE 12
FLORENCE, SC
29501-4909

Practice Phone: 843-678-8998
Practice Fax: 843-678-8999

1497060586 — GERILYN SAMPSON RN
Practice Location Address:

2724 W PALMETTO ST STE 5
FLORENCE, SC
29501-4909

Practice Phone: 513-280-0667
Practice Fax:

1447536727 — LEAH HAMOY LLC
Practice Location Address:

2724 W PALMETTO ST , SUITE 2
FLORENCE, SC
29501-4909

Practice Phone: 843-292-1900
Practice Fax: 843-292-1902

1295217545 — MS. TYNAKA KWANS WILSON APRN
Practice Location Address:

2724 W PALMETTO ST STE 12
FLORENCE, SC
29501-4909

Practice Phone: 843-687-9852
Practice Fax: 937-606-3077

1215492129 — CORA SOUTH CAROLINA LLC
Practice Location Address:

2724 W PALMETTO ST STE 2
FLORENCE, SC
29501-4909

Practice Phone: 843-292-1900
Practice Fax:

Directions to “PALMETTO SLEEP LAB LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.