Provider Demographics
NPI:1861567943
Name:WELLNESS FIRST
Entity type:Organization
Organization Name:WELLNESS FIRST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-225-9933
Mailing Address - Street 1:1836 ASHLEY RIVER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4781
Mailing Address - Country:US
Mailing Address - Phone:843-225-9933
Mailing Address - Fax:843-225-9939
Practice Address - Street 1:742 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7169
Practice Address - Country:US
Practice Address - Phone:843-225-9933
Practice Address - Fax:843-225-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3026111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8372Medicare PIN
SCU80278Medicare UPIN