NPIMap

Organization Active NPI

Palmetto Oxygen LLC

  • Oxygen Equipment & Supplies (DME)
  • Concord, NC
National Provider Identifier
1588296362
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
PALMETTO OXYGEN LLC
Practice address
744 Church St N
Concord, NC 28025-4336
Phone
(704) 317-1903
NPI assigned
Feb 10, 2020
Last updated
Jan 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Wendy Russalesi
Title
Cco
Phone
(484) 246-9499

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

744 Church St N
Concord, NC 28025-4336

Mailing address

555 E North LN Ste 5075
Conshohocken, PA 19428-2490

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200430000915 NC DME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 4981715620 Practice locations: Concord, NC

Other NPIs with the same Medicare PAC ID 6

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Palmetto Oxygen, LLC744 Church St N, Concord, NC 28025-4336(704) 317-1903 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Blood Glucose Monitors/Supplies (Non-Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Infrared Heating Pads Systems and/or Supplies|Negative Pressure Wound Therapy Pumps/Supp… Does not accept assignmentParticipating since Dec 29, 2000

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Oxygen LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

1143 Executive Cir
Ste E1
Cary, NC 27511
Phone (919) 477-4100

1231 NE Maynard Rd
Cary, NC 27513
Phone (800) 868-8822

4113 Capitol St
Ste B
Durham, NC 27704
Phone (919) 251-9444

2325 Aberdeen Blvd
Ste C
Gastonia, NC 28054
Phone (704) 831-5000

1018 N Elm St
Greensboro, NC 27401
Phone (336) 878-8822

1767 Old Earnhardt Rd
Kannapolis, NC 28083
Phone (704) 831-5000

1100 S Stratford Rd
Ste 420
Winston Salem, NC 27103
Phone (336) 837-0770

1445 Shop Rd
Ste A
Columbia, SC 29201
Phone (803) 926-0252

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1588296362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E NORTH LN STE 5075",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254336",
            "telephone_number": "704-317-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO OXYGEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "RUSSALESI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "484-246-9499"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "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": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.