Provider Demographics
NPI:1255606166
Name:HOSPICE OF THE PALMETTO STATE, LLC
Entity type:Organization
Organization Name:HOSPICE OF THE PALMETTO STATE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-332-3995
Mailing Address - Street 1:210 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4304
Mailing Address - Country:US
Mailing Address - Phone:843-332-3995
Mailing Address - Fax:843-332-3994
Practice Address - Street 1:210 S 2ND ST
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4304
Practice Address - Country:US
Practice Address - Phone:843-332-3995
Practice Address - Fax:843-332-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based