Healthcare Provider Details

I. General information

NPI: 1740121136
Provider Name (Legal Business Name): MRS. GWANDA HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2126 HIGHWAY 9 E STE A4
LONGS SC
29568-5725
US

IV. Provider business mailing address

2126 HIGHWAY 9 E STE A4
LONGS SC
29568-5725
US

V. Phone/Fax

Practice location:
  • Phone: 843-399-3395
  • Fax:
Mailing address:
  • Phone: 843-222-4144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number34962
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: