Provider Demographics
NPI:1689081408
Name:HEALTH EDGE GROUP. LLC
Entity Type:Organization
Organization Name:HEALTH EDGE GROUP. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-670-8703
Mailing Address - Street 1:2102 OTRANTO BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9841
Mailing Address - Country:US
Mailing Address - Phone:843-569-2225
Mailing Address - Fax:843-863-1830
Practice Address - Street 1:2102 OTRANTO BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9841
Practice Address - Country:US
Practice Address - Phone:843-569-2225
Practice Address - Fax:843-863-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty