PM HEALTH ALLIANCE LLC NPI 1326590746

NPI Information

NPI: 1326590746
Provider Name: PM HEALTH ALLIANCE, LLC

Doing Business As: BACK 2 HEALTH

Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
588 OLD MOUNT HOLLY RD
GOOSE CREEK, SC
ZIP 29445
Phone: (843) 376-5595
Get Directions

PM HEALTH ALLIANCE, LLC is a primary care nurse practitioner in Goose Creek, SC. PM HEALTH ALLIANCE, LLC NPI is 1326590746. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Back 2 Health.

The provider's business location address is:

588 OLD MOUNT HOLLY RD
GOOSE CREEK, SC
ZIP 29445-814
Phone: (843) 376-5595
Fax: (843) 797-7432

The provider's authorized official is Adam Brandon Hall .
The authorized official title is Owner and has the following contact phone number (843) 376-5595.

The CLIA number assigned to this NPI record is 42D2232975 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/2/2016 and was last updated on 4/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor				No
2	208100000X	Physical Medicine & Rehabilitation				No
3	208600000X	Surgery				No
4	208600000X	Surgery		10054	SOUTH CAROLINA	No
5	208VP0000X	Pain Medicine	Pain Medicine			No
6	225100000X	Physical Therapist				No
7	363A00000X	Physician Assistant				No
8	363L00000X	Nurse Practitioner				No
9	363LP2300X	Nurse Practitioner	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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