Healthy Living Wellness and Healthcare

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

HEALTHY LIVING WELLNESS AND HEALTHCARE

Practice address

105 S Franklin Dr
Florence, SC 29501-4364

Phone

(843) 617-3226

NPI assigned

Jan 9, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tierra Nicole Widder

Title

Authorized Official

Phone

(843) 617-3226

Specialties & licenses 1

Addresses

Other names 1

• Healthy Living Wellness and Healthcare, LLC Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1669989901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S FRANKLIN DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014364",
            "telephone_number": "843-617-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S FRANKLIN DR",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014364",
            "telephone_number": "843-617-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING WELLNESS AND HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "WIDDER",
        "authorized_official_first_name": "TIERRA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "843-617-3226"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Living Wellness and Healthcare, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Primary Care Clinic/Center in Florence, SC
• Providers in Florence, SC by specialty
• Primary Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.