Provider Demographics
NPI:1164022372
Name:PALMETTO MEDICAL TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:PALMETTO MEDICAL TRANSPORTATION, LLC
Other - Org Name:CRESCENT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-827-1980
Mailing Address - Street 1:161 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-6043
Mailing Address - Country:US
Mailing Address - Phone:803-809-0022
Mailing Address - Fax:740-474-8172
Practice Address - Street 1:161 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-6043
Practice Address - Country:US
Practice Address - Phone:803-707-5472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance