Palmetto AIDS Life Support Services

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PALMETTO AIDS LIFE SUPPORT SERVICES

Practice address

2638 Two Notch Rd
Suite 108
Columbia, SC 29204-1454

Phone

(803) 779-7257

Fax

(803) 779-5285

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Carmen Hampton Julious, LISW-CP&AP

Title

Executive Director

Phone

(803) 779-7257

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PALSS Other name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Tax ID family

Palmetto AIDS Life Support Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Palmetto Family Service Center of SC

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1053730572
  NPD tax ID
• Palmetto Family Service Center, LLC

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1871986158
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Palmetto Family Service Center of SC

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1053730572
  NPPES parent name
• Palmetto Family Service Center, LLC

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1871986158
  NPPES parent name

Practitioners 2

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

• Towanna Shanett-Lance Enoch, NP-C

  • Adult Health Nurse Practitioner
  • Columbia, SC
  • NPI 1982709069
  Medicare reassignment Care Compare group NPD
• Leroy J. Huffman, MD

  • Internal Medicine Physician
  • Columbia, SC
  • NPI 1881689032
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1184829392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2638 TWO NOTCH RD",
            "address_2": "SUITE 108",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041454",
            "telephone_number": "803-779-7257",
            "fax_number": "803-779-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2638 TWO NOTCH RD",
            "address_2": "SUITE 108",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292041454",
            "telephone_number": "803-779-7257",
            "fax_number": "803-779-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO AIDS LIFE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "JULIOUS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "HAMPTON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "803-779-7257",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LISW-CP&AP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EX0210",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALSS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Valisa Palmer
• Willetta R.J. Palmer, ARNP
• Palmetto Acupuncture Clinic
• Palmetto Advanced Mobile Wound Care PC
• Palmetto Advocates
• Palmetto Allergy & Asthma PA
• Palmetto Anesthesiology Consultants, LLC
• Palmetto Anesthesiology Medicine
• Palmetto Autism Interventions, LLC
• Palmetto Biotech Prosthetics & Orthotics LLC

• Primary Care Clinic/Center in Columbia, SC
• Providers in Columbia, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.