Healthcare Provider Details

I. General information

NPI: 1679631287
Provider Name (Legal Business Name): IN-HOME HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 S FRASER STREET
GEORGETOWN SC
29440-3910
US

IV. Provider business mailing address

PO BOX 398
GEORGETOWN SC
29442-0398
US

V. Phone/Fax

Practice location:
  • Phone: 843-527-2752
  • Fax: 843-545-9854
Mailing address:
  • Phone: 843-527-2752
  • Fax: 843-545-9854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICK T ETHRIDGE
Title or Position: VP
Credential:
Phone: 843-527-2752