Basic Information
| Provider Information | |||||||||
| NPI: | 1942688122 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PALMETTO HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 PICKENS ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292013465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032962726 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1400 PICKENS ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292013465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032962726 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2015 | ||||||||
| LastUpdateDate: | 05/08/2015 | ||||||||
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| AuthorizedOfficialLastName: | BEAMON | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8032962726 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 19439 | SC | Y | Hospitals | General Acute Care Hospital |
No ID Information.