MEDICARE: EBENEZER OF MB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	385H00000X	Respite Care
2	253Z00000X	In Home Supportive Care Agency
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1134912017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EBENEZER OF MB

Provider Business Mailing Address
First Line	:	2423 HIGHWAY 17 S
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-4343
Country	:	US
Telephone Number	:	843-306-9922
Fax Number	:	843-808-5020

Provider Business Practice Location Address
First Line	:	2423 HIGHWAY 17 S
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-4343
Country	:	US
Telephone Number	:	843-306-9922
Fax Number	:	843-808-5020

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JONATHAN FRANCIS
Credential	:
Telephone Number	:	843-306-9922

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	09/16/2025

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Directions to “EBENEZER OF MB ” Practice Location

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