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General NPI Number Information
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NPI Number | 1578940847
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Entity Type | Organization
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Legal Business Name | HYPERTENSION AND DIABETES PREVENTION AND TREATMENT CENTER LLC
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 118 N. MAIN ST.
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City | DARLINGTON
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State | SC
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Zip | 29532
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Country | US
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Telephone | 843-968-8333
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Fax |
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Provider Business Mailing Address
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Address Line | 118 N. MAIN ST.
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City | DARLINGTON
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State | SC
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Zip | 29532
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Country | US
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Telephone | 843-968-8333
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITONER
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Name | EVELYN R COE
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Credential | FNP
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Telephone | 843-968-8333
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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 | APRN 1734
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License Number State | SC
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