Organization
PALMETTO SLEEP LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY MILTON CAPELL (OWNER)
(843) 444-0800
Entity
Organization
Contact information
Practice address
610A OCEAN HWY W, SUPPLY, NC 28462-4048
(843) 444-0800
(843) 357-1471
Mailing address
PO BOX 1226, MYRTLE BEACH, SC 29578-1226
(843) 444-0800
(843) 357-1471
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5920218
—
NC
Enumeration date
04/18/2013
Last updated
04/18/2013
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