| Organization Name: | PALMETTO PICC LINES, LLC |
| NPI Number: | 1932404589 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHAWN WEST (PRESIDENT) |
| Mailing Address: | 5804 Cardiff Ct Hanahan |
| State: | SC US |
| Postal Code: | 294102402 |
| Phone Number: | 8435682716 |
| Fax Number: | |
| NPI Enumeration Date: | 01/12/2011 |
| NPI Last Update Date: | 01/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WI0500X |
| License Number: | 988 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Infusion Therapy |
| Taxonomy Definition: | |