Healthcare Provider Details
I. General information
NPI: 1356944193
Provider Name (Legal Business Name): HELSE ALLIANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2020
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 PATEWOOD DRIVE SUITE B400
GREENVILLE SC
29615
US
IV. Provider business mailing address
10 TOY STREET SUITE 100
GREENVILLE SC
29601
US
V. Phone/Fax
- Phone: 864-454-4368
- Fax: 864-454-4348
- Phone: 833-450-0514
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YP0228X |
| Taxonomy | Pediatric Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
OSBORNE
BROWN
III
Title or Position: OWNER
Credential: MD
Phone: 833-450-0514