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Organization
360 CHRONIC CARE MANAGEMENT
Active
Organization
360 CHRONIC CARE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUANETHEA BRYANTLORD MVHWC (BUSINESS OWNER)
(803) 243-1066
Entity
Organization
Contact information
Practice address
35 VARDEN DR STE A-1, AIKEN, SC 29803-5275
(803) 243-1066
(803) 226-0335
Mailing address
35 VARDEN DR STE A-1, AIKEN, SC 29803-5275
(803) 243-1066
(803) 226-0335
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
—
—
163WG0000X
General Practice Registered Nurse
—
—
163WG0600X
Gerontology Registered Nurse
—
—
163WN1003X
Nutrition Support Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
171400000X
Health & Wellness Coach
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
225700000X
Massage Therapist
—
—
363L00000X
Nurse Practitioner
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LC1500X
Community Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG2956
—
SC
Enumeration date
03/11/2024
Last updated
06/24/2025
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