| Healistic Wound Care Management Group | |
|
2724 W Palmetto St Ste 12 Florence SC 29501-4909 | |
| (843) 992-2754 | |
| Not Available |
| Full Name | Healistic Wound Care Management Group |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2724 W Palmetto St Ste 12, Florence, South Carolina |
| Authorized Official Name and Position | Hillery Dolford (OWNER) |
| Authorized Official Contact | 8439922754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healistic Wound Care Management Group 2724 W Palmetto St Ste 12 Florence SC 29501-4909 Ph: (843) 992-2754 | Healistic Wound Care Management Group 2724 W Palmetto St Ste 12 Florence SC 29501-4909 Ph: (843) 992-2754 |
| NPI Number | 1205625985 |
|---|---|
| Provider Enumeration Date | 05/01/2025 |
| Last Update Date | 05/01/2025 |
| Certification Date | 05/01/2025 |
| Medicare PECOS PAC ID | 9032607155 |
|---|---|
| Medicare Enrollment ID | O20251021003909 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205625985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (NU) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (NU) | Primary |
| Provider Name | Hillery L Dolford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104283548 PECOS PAC ID: 7214236835 Enrollment ID: I20160504000416 |
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