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General NPI Number Information
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NPI Number | 1700353240
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Entity Type | Organization
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Legal Business Name | HEALTH CORE DIRECT
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 11/01/2018
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Provider Practice Location Address
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Address Line | 101 N PINE ST STE 210
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City | SPARTANBURG
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State | SC
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Zip | 29302-1604
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Country | US
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Telephone | 864-358-9278
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Fax |
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Provider Business Mailing Address
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Address Line | 101 N PINE ST STE 210
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City | SPARTANBURG
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State | SC
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Zip | 29302-1604
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Country | US
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Telephone | 864-358-9278
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACEY D MILLER
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Credential | NP
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Telephone | 864-439-0959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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