Provider Demographics
NPI:1619517133
Name:EHEALTH MEDICAL SYSTEMS
Entity Type:Organization
Organization Name:EHEALTH MEDICAL SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-306-6105
Mailing Address - Street 1:1526 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-7603
Mailing Address - Country:US
Mailing Address - Phone:843-639-7484
Mailing Address - Fax:843-306-6515
Practice Address - Street 1:200 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:SC
Practice Address - Zip Code:29525-3001
Practice Address - Country:US
Practice Address - Phone:843-306-6105
Practice Address - Fax:843-306-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty