Provider Demographics
NPI:1194361857
Name:PALMETTO HOME HEALTHCARE
Entity Type:Organization
Organization Name:PALMETTO HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:AUDRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN BSN RN
Authorized Official - Phone:843-297-5179
Mailing Address - Street 1:1335 RONALD LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8227
Mailing Address - Country:US
Mailing Address - Phone:843-297-5179
Mailing Address - Fax:843-795-7317
Practice Address - Street 1:1335 RONALD LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-8227
Practice Address - Country:US
Practice Address - Phone:843-297-5179
Practice Address - Fax:843-795-7317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care