NPIMap

Organization Active NPI

Palmetto Infusion Services, LLC

  • Home Infusion Therapy Pharmacy
  • Florence, SC
National Provider Identifier
1154814630
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
Legal business name
PALMETTO INFUSION SERVICES, LLC
Practice address
217 Dozier Blvd Ste 102
Florence, SC 29501-4090
Phone
(800) 809-1265
Fax
(866) 872-8920
NPI assigned
Jun 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Connie Hartley
Title
Chief Reimbursement Officer
Phone
(803) 277-5447

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Pharmacy 333600000X
Compounding Pharmacy 3336C0004X
Home Infusion Therapy Pharmacy 3336H0001X Primary

Addresses

Primary practice location

217 Dozier Blvd Ste 102
Florence, SC 29501-4090

Mailing address

PO Box 538476
Atlanta, GA 30353-8476
Phone (800) 809-1265

Other identifiers 1

IdentifierTypeStateIssuer
2178061OtherPK

Other names 1

  • Palmetto Infusion Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180908000046 SC DME Supplier - Pharmacy 4688578826 Practice locations: Florence, SC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2305165Palmetto Infusion Services - Florence217 Dozier Blvd, Suite 101, Florence, SC 29501Certificate of waiverMay 27, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Palmetto Infusion Services LLC217 Dozier Blvd, Florence, SC 29501-4090(800) 809-1265 Infusion Drugs|External Infusion Pumps and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 1990

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Infusion Services LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

217 Dozier Blvd
Ste 102
Florence, SC 29501

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 60

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1154814630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538476",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303538476",
            "telephone_number": "800-809-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 DOZIER BLVD STE 102",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014090",
            "telephone_number": "800-809-1265",
            "fax_number": "866-872-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO INFUSION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2023-08-03",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "CHIEF REIMBURSEMENT OFFICER",
        "authorized_official_telephone_number": "803-277-5447"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2178061",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmetto Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.