THRIVE ESSENTIAL WELLNESS INC. NPI 1407342116

NPI Information

NPI: 1407342116
Provider Name: THRIVE ESSENTIAL WELLNESS, INC.
Classification: Physician Assistant - 363AM0700X
Entity Type: Organization

Specialization: Medical

Address:
1511 9TH AVE STE A
CONWAY, SC
ZIP 29526
Phone: (843) 488-1894
Get Directions

THRIVE ESSENTIAL WELLNESS, INC. is a medical physician assistant in Conway, SC. THRIVE ESSENTIAL WELLNESS, INC. NPI is 1407342116. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1511 9TH AVE STE A
CONWAY, SC
ZIP 29526-126
Phone: (843) 488-1894
Fax: (843) 488-2786

The provider's authorized official is Greg D Tallent .
The authorized official title is Pa-c, Vice President and has the following contact phone number (843) 251-6688.

The enumeration date for this NPI number is 7/5/2018 and was last updated on 7/5/2018.

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	363AM0700X	Physician Assistant	Medical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1982716585	MEDICAID	SOUTH CAROLINA
2	1982716585	OTHER	SOUTH CAROLINA	BC/BS
3	1942532023	OTHER	SOUTH CAROLINA	BC/BS
4	1245535574	OTHER	SOUTH CAROLINA	BC/BS
5	1982716586	OTHER	SOUTH CAROLINA	BC/BS
6	1942532023	MEDICAID	SOUTH CAROLINA
7	1245535574	MEDICAID	SOUTH CAROLINA

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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