=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316242092
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PALMETTO CARDIOLOGY OF YORK COUNTY, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2011
-----------------------------------------------------
Last Update Date | 11/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 430 HERLONG AVE S STE 104
-----------------------------------------------------
City | ROCK HILL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29732-1094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-324-4900
-----------------------------------------------------
Fax | 803-324-1155
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 430 HERLONG AVE S STE 104
-----------------------------------------------------
City | ROCK HILL
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29732-1094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-324-4900
-----------------------------------------------------
Fax | 833-559-1046
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. HARRY EUGENE HICKLIN III
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 803-324-4900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------