Provider Demographics
NPI:1386380590
Name:PALMETTO SENIOR CARE
Entity type:Organization
Organization Name:PALMETTO SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HIERS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:601-926-1181
Mailing Address - Street 1:807 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-3729
Mailing Address - Country:US
Mailing Address - Phone:601-926-1181
Mailing Address - Fax:601-926-1184
Practice Address - Street 1:807 MONROE ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-3729
Practice Address - Country:US
Practice Address - Phone:601-926-1181
Practice Address - Fax:601-926-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care