Provider Demographics
NPI:1992716351
Name:PALMETTO BREATHING SOLUTIONS, INC.
Entity type:Organization
Organization Name:PALMETTO BREATHING SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-393-1001
Mailing Address - Street 1:18 PUBLIC SQ
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-3212
Mailing Address - Country:US
Mailing Address - Phone:843-393-1001
Mailing Address - Fax:800-865-0551
Practice Address - Street 1:18 PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3212
Practice Address - Country:US
Practice Address - Phone:843-393-1001
Practice Address - Fax:800-865-0551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2325Medicaid
SC4309340001Medicare NSC