Basic Information
| Provider Information | |||||||||
| NPI: | 1316963481 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PALMETTO HEALTH TUOMEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 129 N WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291504949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037749000 | ||||||||
| FaxNumber: | 8037749589 | ||||||||
| Practice Location | |||||||||
| Address1: | 129 N. WASHINGTON STREET | ||||||||
| Address2: | |||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291504949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037749000 | ||||||||
| FaxNumber: | 8037749589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 03/31/2016 | ||||||||
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| AuthorizedOfficialLastName: | LOGAN-OWENS | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 8037748600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | HTL-096 | SC | N | Hospitals | General Acute Care Hospital | 314000000X | NCF-0698 | SC | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 323436 | 05 | SC | MEDICAID | 400701 | 05 | SC | MEDICAID |