Organization
PALMETTO SPECIALTY PHARMACY
Active
Other names
Palmetto Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE HARTLEY (VICE-PRESIDENT)
(803) 227-5447
Entity
Organization
Contact information
Practice address
172 MCSWAIN DR STE C, WEST COLUMBIA, SC 29169-4804
(803) 724-1501
(855) 286-1676
Mailing address
172 MCSWAIN DR, SUITE C, WEST COLUMBIA, SC 29169-4804
(803) 724-1501
(855) 286-1676
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
14939
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143309
PK
—
Enumeration date
12/10/2013
Last updated
12/10/2013
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