Mack, Justin
Mack, Justin is an sole proprietor health care provider with primary practice located at 1951 Pisgah Rd Ste 122 , Florence SC 29501-6705. He recently has only one registered license in Agencies / Home Health, which is considered as his primary health care specialty. Mack, Justin can be contacted via phone (843) 413-2854.Contact Information
Primary practice address
1951 Pisgah Rd Ste 122
Florence SC 29501-6705
Phone: (843) 413-2854
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Home Health | 251E00000X |
Profile Details
| NPI number | 1063041143 |
|---|---|
| LBN Legal business name | Mack, Justin |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 2nd, 2020 |
| Last updated | Oct 7th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063041143 | NPPES |
| South Carolina | Other | 100452463 | LICENSE |
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