Provider Demographics
NPI:1356508659
Name:PALMETTO HEALTH
Entity Type:Organization
Organization Name:PALMETTO HEALTH
Other - Org Name:EASLEY ORTHOPAEDIC CLINIC, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-855-4431
Mailing Address - Street 1:704 N A ST
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-2142
Mailing Address - Country:US
Mailing Address - Phone:864-855-4431
Mailing Address - Fax:864-306-0012
Practice Address - Street 1:704 N A ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-2142
Practice Address - Country:US
Practice Address - Phone:864-855-4431
Practice Address - Fax:864-306-0012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALMETTO HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-22
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC2083Medicaid
SCPC2083Medicaid