MEDICARE: OPTIMUM HEALTHCARE

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	251E00000X	Home Health Agency		SC
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1497075121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM HEALTHCARE

Provider Business Mailing Address
First Line	:	622A OLD EASLEY HWY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-6521
Country	:	US
Telephone Number	:	864-552-1114
Fax Number	:

Provider Business Practice Location Address
First Line	:	622A OLD EASLEY HWY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-6521
Country	:	US
Telephone Number	:	864-992-3883
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TONYA BRYANT
Credential	:
Telephone Number	:	864-992-3883

Provider Enumeration Date	:	06/04/2010
Last Update Date	:	11/25/2019

Similar Medicare Providers

1891237475 — OPTIMUM HEALTHCARE
Practice Location Address:

622A OLD EASLEY HWY
GREENVILLE, SC
29611-6521

Practice Phone: 864-552-1114
Practice Fax:

1942766449 — LASHONDA BURT-REEDER
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1790396844 — TRINITY HEALTHCARE SERVICES LLC
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1568355105 — TONYA BRYANT FNP
Practice Location Address:

622A OLD EASLEY HWY
GREENVILLE, SC
29611-6521

Practice Phone: 864-992-3883
Practice Fax:

1427315290 — MRS. PATRICIA ANN WARD
Practice Location Address:

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1225751068 — ITRUST CARES LLC
Practice Location Address:

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Directions to “OPTIMUM HEALTHCARE ” Practice Location

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