Provider Demographics
NPI:1568559797
Name:PALMETTO HEALTH
Entity Type:Organization
Organization Name:PALMETTO HEALTH
Other - Org Name:CHILDREN'S HOSPITAL EMERGENCY TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR BUSINESS DEV.-FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:C
Authorized Official - Last Name:COVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-296-7301
Mailing Address - Street 1:PO BOX 402145
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2145
Mailing Address - Country:US
Mailing Address - Phone:803-296-7305
Mailing Address - Fax:803-296-7329
Practice Address - Street 1:5 MEDICAL PARK
Practice Address - Street 2:PALMETTO HEALTH DBA CHILDRENS HOSPTIAL EMERGENCY TRANS
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29202-9154
Practice Address - Country:US
Practice Address - Phone:803-434-6043
Practice Address - Fax:803-434-4860
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALMETTO HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-09
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC197341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance