Provider Demographics
NPI:1558033100
Name:PERSONIC HEALTHCARE LLC
Entity Type:Organization
Organization Name:PERSONIC HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:124-072-8904
Mailing Address - Street 1:1 HARBISON WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3422
Mailing Address - Country:US
Mailing Address - Phone:866-986-0580
Mailing Address - Fax:215-933-6837
Practice Address - Street 1:5590 NE 6TH AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-3410
Practice Address - Country:US
Practice Address - Phone:866-986-0580
Practice Address - Fax:215-933-6837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care