Provider Demographics
NPI:1265484422
Name:PALMETTO ANESTHESIA OF CHARLESTON, LLC
Entity Type:Organization
Organization Name:PALMETTO ANESTHESIA OF CHARLESTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BEALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-572-1228
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-0308
Mailing Address - Country:US
Mailing Address - Phone:843-572-1228
Mailing Address - Fax:877-561-7564
Practice Address - Street 1:9263 MEDICAL PLAZA DR
Practice Address - Street 2:STE E
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-7112
Practice Address - Country:US
Practice Address - Phone:843-572-1228
Practice Address - Fax:877-561-7564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDF3518OtherRR MEDICARE
SCGP4029Medicaid
SC8104Medicare UPIN