Organization
PALMETTO OXYGEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY RUSSALESI (CHIEF COMPLIANCE OFFICER)
(484) 246-9499
Entity
Organization
Contact information
Practice address
4790 OLD YORK RD, ROCK HILL, SC 29732-8126
(803) 228-7402
(839) 274-5811
Mailing address
555 E NORTH LN STE 5075, CONSHOHOCKEN, PA 19428-2233
(215) 388-1719
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
65008058
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE1828
—
SC
Enumeration date
07/13/2006
Last updated
12/16/2024
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