Provider Demographics
NPI:1245651819
Name:PALMETTO HOSPITALIST SERVICES LLC
Entity type:Organization
Organization Name:PALMETTO HOSPITALIST SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-359-7527
Mailing Address - Street 1:PO BOX 1733
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-1733
Mailing Address - Country:US
Mailing Address - Phone:803-359-7527
Mailing Address - Fax:
Practice Address - Street 1:2131 WOODRUFF RD STE 2100
Practice Address - Street 2:#269
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5959
Practice Address - Country:US
Practice Address - Phone:248-303-0257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24782261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC24782OtherINDIVIDUAL NPI 1932170305