Provider Demographics
NPI:1922789197
Name:PALMETTO HEALTH PARTNERS OF SC LLC
Entity Type:Organization
Organization Name:PALMETTO HEALTH PARTNERS OF SC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:864-747-7136
Mailing Address - Street 1:2453 LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-8809
Mailing Address - Country:US
Mailing Address - Phone:864-940-3682
Mailing Address - Fax:
Practice Address - Street 1:108 COMMONS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-7766
Practice Address - Country:US
Practice Address - Phone:864-747-7136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty