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General NPI Number Information
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NPI Number | 1598311359
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Entity Type | Organization
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Legal Business Name | GERIATRIC HEALTH AND WELLNESS LTD CO.
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 1 STILL HOPES DR
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-7164
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Country | US
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Telephone | 803-788-5916
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Fax | 803-788-9564
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Provider Business Mailing Address
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Address Line | 115 ATRIUM WAY STE 235
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City | COLUMBIA
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State | SC
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Zip | 29223-6383
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Country | US
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Telephone | 803-788-5916
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Fax | 803-788-9524
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Authorized Official
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Title or Position | OWNER/MD
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Name | DR. VICTOR HIRTH
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Credential | MD
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Telephone | 803-788-5916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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