Provider Demographics
NPI:1043061005
Name:AT HOME HARMONY OF SOUTH CAROLINA PC
Entity Type:Organization
Organization Name:AT HOME HARMONY OF SOUTH CAROLINA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-210-3103
Mailing Address - Street 1:1504 SANTA ROSA RD RM 114
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5109
Mailing Address - Country:US
Mailing Address - Phone:804-210-3103
Mailing Address - Fax:804-288-1538
Practice Address - Street 1:1504 SANTA ROSA RD RM 114
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-5109
Practice Address - Country:US
Practice Address - Phone:804-210-3103
Practice Address - Fax:804-288-1538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty