Organization
PALMETTO HEALTH ALLIANCE
Active
Other names
Palmetto Bone and Joint Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
KENDALL J DURHAM (MANAGER-FINANCIAL SERVICES REP)
(864) 855-5104
Entity
Organization
Contact information
Practice address
112 JOHN ST, SUITE 103, EASLEY, SC 29640-1472
(864) 855-5104
(864) 859-9362
Mailing address
PO BOX 2089, EASLEY, SC 29641-2089
(864) 855-5104
(864) 859-9362
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
23481
SC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE DME
SC
Enumeration date
09/24/2007
Last updated
09/24/2007
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