Provider Demographics
NPI:1487363586
Name:POLESTAR HEALTH AND WELLNESS
Entity type:Organization
Organization Name:POLESTAR HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVEY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:843-708-8566
Mailing Address - Street 1:1702 W ROBINHOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5833
Mailing Address - Country:US
Mailing Address - Phone:843-708-8566
Mailing Address - Fax:
Practice Address - Street 1:1702 W ROBINHOOD DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5833
Practice Address - Country:US
Practice Address - Phone:843-708-8566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care