MEDICARE: ME WORK GLOBAL EMPOWERMENT CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker		SC
2	104100000X	Social Worker	10306	SC

General Provider Information

NPI Number	:	1316446305
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ME WORK GLOBAL EMPOWERMENT CENTER

Provider Business Mailing Address
First Line	:	526 JOHNSON ST
Second Line	:
City	:	CHESTER
State	:	SC
Zip	:	29706-2068
Country	:	US
Telephone Number	:	919-559-8652
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 BW THOMAS DR STE 106
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-7240
Country	:	US
Telephone Number	:	919-559-8652
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MARQUES TIMOTHY JOHNSON JR.
Credential	:
Telephone Number	:	919-559-8652

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	02/06/2018

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