MEDICARE: PRESTIGE HOME HEALTH

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

General Provider Information

NPI Number	:	1740419894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTIGE HOME HEALTH

Provider Business Mailing Address
First Line	:	6 EXECUTIVE CT
Second Line	:
City	:	LAKE WYLIE
State	:	SC
Zip	:	29710-9338
Country	:	US
Telephone Number	:	803-831-6778
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 EXECUTIVE CT
Second Line	:
City	:	LAKE WYLIE
State	:	SC
Zip	:	29710-9338
Country	:	US
Telephone Number	:	803-831-6778
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	SCOTT GALBRIETH
Credential	:
Telephone Number	:	803-831-6778

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	07/10/2009

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Directions to “PRESTIGE HOME HEALTH ” Practice Location

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