Healthcare Provider Details

I. General information

NPI: 1164403184
Provider Name (Legal Business Name): FLORENCE VISITING NURSES SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2527 S CASHUA DR
FLORENCE SC
29501-5350
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 843-667-1515
  • Fax: 843-667-0076
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-443-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA064
License Number StateSC

VIII. Authorized Official

Name: MR. JOSHUA L PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307