Provider Demographics
NPI:1366869190
Name:WINNING HEALTH WELLNESS LLC
Entity Type:Organization
Organization Name:WINNING HEALTH WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCMARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-471-0375
Mailing Address - Street 1:966 HOUSTON NORTHCUTT BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3487
Mailing Address - Country:US
Mailing Address - Phone:843-471-0375
Mailing Address - Fax:
Practice Address - Street 1:966 HOUSTON NORTHCUTT BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3487
Practice Address - Country:US
Practice Address - Phone:843-471-0375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCI64466Medicare UPIN