MEDICARE: COURTEOUS CARE COORDINATION

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1992656128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COURTEOUS CARE COORDINATION

Provider Business Mailing Address
First Line	:	2601 READ ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-7861
Country	:	US
Telephone Number	:	803-413-9105
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 READ ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-7861
Country	:	US
Telephone Number	:	803-413-9105
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADRIADNE LONG
Credential	:
Telephone Number	:	803-413-9105

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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