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PALMETTO FAMILY CARE NPI 1790765972


NPI Information

NPI: 1790765972
Provider Name: PALMETTO FAMILY CARE
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 42D1027893

Address:
1455 REMOUNT RD
SUITE 1A & 1B
NORTH CHARLESTON, SC
ZIP 29406
Phone: (843) 745-9990
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PALMETTO FAMILY CARE is a family medicine in North Charleston, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PALMETTO FAMILY CARE NPI is 1790765972. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1455 REMOUNT RD
SUITE 1A & 1B
NORTH CHARLESTON, SC
ZIP 29406-355
Phone: (843) 745-9990
Fax: (843) 745-0008

The provider's authorized official is Herold Nazon .
The authorized official title is President and has the following contact phone number (843) 745-9990.

The CLIA number assigned to this NPI record is 42D1027893 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/22/2006 and was last updated on 10/18/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineSC12512SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1D84774MEDICARE UPINSOUTH CAROLINA
2GP2608MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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