Palmetto Corner, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PALMETTO CORNER, LLC

Practice address

12360 Palmetto Church Rd
Princess Anne, MD 21853-4046

Phone

(410) 881-5200

NPI assigned

Feb 2, 2020

Organization subpart

No

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

Authorized official

Name

Richard A. RenshawNPI 1407489693

Title

Owner

Phone

(410) 881-5200

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Tax ID family

Palmetto Corner LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Palmetto Corner, LLC

  • Substance Abuse Rehabilitation Facility
  • Parsonsburg, MD
  • NPI 1275292567
  NPD tax ID

Locations

Practitioners 1

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

• Richard A. Renshaw

  • Specialist
  • Princess Anne, MD
  • NPI 1407489693
  NPD Authorized official

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

{
    "created_epoch": "1580601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1922639558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3640",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218023640",
            "telephone_number": "410-881-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 PALMETTO CHURCH RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218534046",
            "telephone_number": "410-881-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO CORNER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-02",
        "last_updated": "2021-07-22",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "RENSHAW",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-881-5200"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Next Chapter Behavioral Health LLC
• Geoffrey Ngam
• Charles Wheeler Novak, CRNP-PMH
• Nu Pathway Healthcare and Wellness LLC
• Kristine Oladayo Oladipo, DDS
• James Hyun Park, PHARMD
• Donna F Parker, MD
• Madeline Anne Parler, LMSW
• Tisa Massey Parsons, CRNP
• Asmitaben A Patel

• Substance Abuse Rehabilitation Facility in Princess Anne, MD
• Providers in Princess Anne, MD by specialty
• Substance Abuse Rehabilitation Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.