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General NPI Number Information
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NPI Number | 1326594730
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Entity Type | Organization
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Legal Business Name | PAWLEYS SERVICE PARTNERS LLC
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Dates
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Enumeration Date | 08/27/2016
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 237A WILLBROOK BLVD
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-7789
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Country | US
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Telephone | 843-485-0342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2651
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-2651
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Country | US
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Telephone | 843-485-0342
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TRAVA HENDRIX
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Credential |
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Telephone | 843-485-0342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | IHCP-0473
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License Number State | SC
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