Convenient Concierge Healthcare

Key facts

NPI

1184090763

Entity type

Organization (NPI type 2)

Primary specialty

Multi-Specialty Clinic/Center 261QM1300X

Legal business name

CONVENIENT CONCIERGE HEALTHCARE

Practice address

922 Jericho CT
Myrtle Beach, SC 29579-3422

Phone

(704) 658-6483

NPI assigned

Aug 18, 2015

Organization subpart

Yes

Parent organization (as reported)

CONVENIENT CONCIERGE HEALTHCARE

Authorized official

Name

Ms. Denise Vansant

Title

President

Phone

(704) 658-6483

National Provider Directory

Part of

Convenient Concierge Healthcare

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 18, 2015.

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1184090763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 JERICHO CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793422",
            "telephone_number": "704-658-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 JERICHO CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793422",
            "telephone_number": "704-658-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT CONCIERGE HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONVENIENT CONCIERGE HEALTHCARE",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "VANSANT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-658-6483",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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