Provider Demographics
NPI:1356495618
Name:HEALTHY LIVING SYSTEMS, INC.
Entity Type:Organization
Organization Name:HEALTHY LIVING SYSTEMS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:T
Authorized Official - Last Name:PETROSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-286-6410
Mailing Address - Street 1:2076 MOUNT LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-7600
Mailing Address - Country:US
Mailing Address - Phone:803-286-6410
Mailing Address - Fax:803-286-6411
Practice Address - Street 1:2076 MOUNT LAUREL RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-7600
Practice Address - Country:US
Practice Address - Phone:803-286-6410
Practice Address - Fax:803-286-6411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2432Medicaid