Provider Demographics
NPI:1871044859
Name:HARTSVILLE MEDICAL ENRICHMENT SERVICES LLC
Entity Type:Organization
Organization Name:HARTSVILLE MEDICAL ENRICHMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEFFIELD-WILKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-968-8210
Mailing Address - Street 1:24 PUBLIC SQ
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-3212
Mailing Address - Country:US
Mailing Address - Phone:843-968-8210
Mailing Address - Fax:
Practice Address - Street 1:24 PUBLIC SQ
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3212
Practice Address - Country:US
Practice Address - Phone:843-968-8210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty