| Palmetto Specialty Long Term Care | |
|
2315 Gadsden St Columbia SC 29201-2038 | |
| (803) 260-1019 | |
| Not Available |
| Full Name | Palmetto Specialty Long Term Care |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2315 Gadsden St, Columbia, South Carolina |
| Authorized Official Name and Position | Kevin John Mcdermott (OWNER/CEO) |
| Authorized Official Contact | 8435134120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Specialty Long Term Care 2315 Gadsden St Columbia SC 29201-2038 Ph: (803) 260-1019 | Palmetto Specialty Long Term Care 2315 Gadsden St Columbia SC 29201-2038 Ph: (803) 260-1019 |
| NPI Number | 1730860552 |
|---|---|
| Provider Enumeration Date | 07/25/2023 |
| Last Update Date | 03/26/2024 |
| Certification Date | 03/26/2024 |
| Medicare PECOS PAC ID | 6709239007 |
|---|---|
| Medicare Enrollment ID | O20240201003344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730860552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jamae C Mcdermott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700918562 PECOS PAC ID: 4082881032 Enrollment ID: I20120117000229 |
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