Healthcare Provider Details

I. General information

NPI: 1326485442
Provider Name (Legal Business Name): HEALTH FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 05/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 N MAIN ST
SUMMERVILLE SC
29483-7847
US

IV. Provider business mailing address

8740 RIVERS AVE
NORTH CHARLESTON SC
29406-9211
US

V. Phone/Fax

Practice location:
  • Phone: 843-572-5990
  • Fax:
Mailing address:
  • Phone: 843-572-5990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number13512
License Number StateSC

VIII. Authorized Official

Name: GASTON MACHADO
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 843-572-5990