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General NPI Number Information
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NPI Number | 1275287732
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Entity Type | Organization
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Legal Business Name | SOUTHERN COMFORT HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 1032 BENTWOOD RD
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City | HARTSVILLE
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State | SC
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Zip | 29550-5080
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Country | US
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Telephone | 843-773-0979
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Fax |
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Provider Business Mailing Address
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Address Line | 1032 BENTWOOD RD
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City | HARTSVILLE
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State | SC
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Zip | 29550-5080
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Country | US
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Telephone | 843-773-0979
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Fax |
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Authorized Official
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Title or Position | OWNER/FNP
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Name | ANGELA NICOLE WILLIAMSON
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Credential | FNP
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Telephone | 843-773-0979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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