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General NPI Number Information
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NPI Number | 1487363586
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Entity Type | Organization
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Legal Business Name | POLESTAR HEALTH AND WELLNESS
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 1702 W ROBINHOOD DR
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City | CHARLESTON
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State | SC
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Zip | 29407-5833
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Country | US
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Telephone | 843-708-8566
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 W ROBINHOOD DR
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City | CHARLESTON
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State | SC
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Zip | 29407-5833
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Country | US
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Telephone | 843-708-8566
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Fax |
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Authorized Official
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Title or Position | PARTNER/PROVIDER
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Name | ALEXANDER HOVEY
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Credential | PA-C
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Telephone | 843-708-8566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service 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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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