Provider Demographics
NPI:1639469117
Name:PALMETTO PRIMARY CARE PHYSICIANS, LLC
Entity Type:Organization
Organization Name:PALMETTO PRIMARY CARE PHYSICIANS, LLC
Other - Org Name:LOWCOUNTRY SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:BRANTLEY
Authorized Official - Last Name:ARNAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-572-7727
Mailing Address - Street 1:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-695-6071
Mailing Address - Fax:843-569-5881
Practice Address - Street 1:7 S ALLIANCE DR
Practice Address - Street 2:STE 202-A
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-7269
Practice Address - Country:US
Practice Address - Phone:843-820-5315
Practice Address - Fax:843-376-2764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC123632084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPL0102Medicaid
SC5282Medicare PIN