Provider Demographics
NPI:1578954426
Name:HEALTHWORKS MEDICAL LLC
Entity Type:Organization
Organization Name:HEALTHWORKS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:KRAICHELY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-821-8787
Mailing Address - Street 1:1240C CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-3148
Mailing Address - Country:US
Mailing Address - Phone:843-821-8787
Mailing Address - Fax:843-821-8799
Practice Address - Street 1:1240C CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-3148
Practice Address - Country:US
Practice Address - Phone:843-821-8787
Practice Address - Fax:843-821-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty