Provider Demographics
NPI:1467741496
Name:PALM TREE ENTERPRISES LLC
Entity Type:Organization
Organization Name:PALM TREE ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLINGTON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:METCALFE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:317-408-6824
Mailing Address - Street 1:4803 MANNING RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-2052
Mailing Address - Country:US
Mailing Address - Phone:317-408-6824
Mailing Address - Fax:
Practice Address - Street 1:4803 MANNING RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46228-2052
Practice Address - Country:US
Practice Address - Phone:317-408-6824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251J00000XAgenciesNursing Care
No347C00000XTransportation ServicesPrivate Vehicle