Healthcare Provider Details

I. General information

NPI: 1063055515
Provider Name (Legal Business Name): MATCH POINT HILTON HEAD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CORPUS CHRISTIE PL STE 101
HILTON HEAD SC
29928-1718
US

IV. Provider business mailing address

2 CORPUS CHRISTIE PL STE 101
HILTON HEAD SC
29928-1718
US

V. Phone/Fax

Practice location:
  • Phone: 917-689-7467
  • Fax:
Mailing address:
  • Phone: 917-689-7467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARK J PIEGZA
Title or Position: OWNER
Credential:
Phone: 917-689-7467