Provider Demographics
NPI:1902829500
Name:PALMETTO SEATING & MOBILITY
Entity Type:Organization
Organization Name:PALMETTO SEATING & MOBILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-296-6911
Mailing Address - Street 1:780 TILLOTSON RD.
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-296-6911
Mailing Address - Fax:864-296-6910
Practice Address - Street 1:780 TILLOTSON RD.
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-296-6911
Practice Address - Fax:864-296-6910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARRETT GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-25
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC004294301332B00000X, 332BC3200X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2229Medicaid