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General NPI Number Information
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NPI Number | 1235431438
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Entity Type | Organization
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Legal Business Name | HARTSVILLE MEDICAL ENRICHMENT SERVICES, LLC
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Dates
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Enumeration Date | 11/22/2010
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 24 PUBLIC SQ
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City | DARLINGTON
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State | SC
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Zip | 29532-3212
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Country | US
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Telephone | 843-968-8210
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Fax | 843-393-2326
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Provider Business Mailing Address
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Address Line | 511 E HOME AVE
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City | HARTSVILLE
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State | SC
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Zip | 29550-3729
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Country | US
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Telephone | 843-319-0146
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Fax | 843-393-2326
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Authorized Official
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Title or Position | CFO
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Name | MR. WAYNE SIMON
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Credential |
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Telephone | 843-319-0146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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