Provider Demographics
NPI:1346662624
Name:PALMETTO HOSPITALIST SERVICES LLC
Entity Type:Organization
Organization Name:PALMETTO HOSPITALIST SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSPARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-303-0257
Mailing Address - Street 1:PO BOX 1733
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-1733
Mailing Address - Country:US
Mailing Address - Phone:803-359-7527
Mailing Address - Fax:803-359-6265
Practice Address - Street 1:2131 WOODRUFF RD
Practice Address - Street 2:SUITE 2100 #269
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5950
Practice Address - Country:US
Practice Address - Phone:248-303-0257
Practice Address - Fax:877-348-8216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care