Provider Demographics
NPI:1588445324
Name:HEALTH CORE MEDICAL & AESTHETICS INC
Entity type:Organization
Organization Name:HEALTH CORE MEDICAL & AESTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:864-680-8376
Mailing Address - Street 1:511 CRICKET RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8877
Mailing Address - Country:US
Mailing Address - Phone:864-680-8376
Mailing Address - Fax:864-448-1661
Practice Address - Street 1:2992 REIDVILLE RD STE 201
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-5634
Practice Address - Country:US
Practice Address - Phone:864-319-2535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty