Healthcare Provider Details
I. General information
NPI: 1366821191
Provider Name (Legal Business Name): HEALTH HERO USA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2015
Last Update Date: 06/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23 MANHATTAN SQUARE
HAMPTON VA
23666
US
IV. Provider business mailing address
326 PRAIRIE STREET NORTH
UNION SPRINGS AL
36089-1417
US
V. Phone/Fax
- Phone: 205-609-0268
- Fax: 866-737-9625
- Phone: 205-609-0268
- Fax: 866-737-9625
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
LIBERTY
DUKE
Title or Position: PRESIDENT
Credential:
Phone: 334-220-2484