1427111913 NPI number — PALMETTO HEALTH

Table of content: (NPI 1427111913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427111913 NPI number — PALMETTO HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PALMETTO HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
OCONEE COUNSELING CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427111913
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 JOHN ST STE 102
Provider Second Line Business Mailing Address:
THE PASTORAL COUNSELING CENTER OF EASLEY
Provider Business Mailing Address City Name:
EASLEY
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29640-1405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-442-7585
Provider Business Mailing Address Fax Number:
864-859-9648

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1659 SANDIFER BLVD
Provider Second Line Business Practice Location Address:
THE OCONEE COUNSELING CENTER
Provider Business Practice Location Address City Name:
SENECA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29678-0906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-293-7585
Provider Business Practice Location Address Fax Number:
864-859-9648
Provider Enumeration Date:
12/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ECKERT
Authorized Official First Name:
TOM
Authorized Official Middle Name:
Authorized Official Title or Position:
CORP DIRECTOR, PT FINANCIAL SVCS
Authorized Official Telephone Number:
803-296-2443

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)