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General NPI Number Information
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NPI Number | 1568818177
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Entity Type | Organization
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Legal Business Name | CONCORD WELLNESS CENTER & HOME HEALTH
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 4126 CLEMSON BLVD SUITE 1A
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City | ANDERSON
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State | SC
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Zip | 29621-1113
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Country | US
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Telephone | 864-760-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 4126 CLEMSON BLVD SUITE 1A
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City | ANDERSON
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State | SC
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Zip | 29621-1113
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Country | US
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Telephone | 864-760-1010
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATASHA L RHONE
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Credential | RN
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Telephone | 864-760-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 17933
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 19338
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License Number State | SC
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