Healthcare Provider Details

I. General information

NPI: 1245679612
Provider Name (Legal Business Name): HB ENTERPRISE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 PRINCE ST
GEORGETOWN SC
29440-2930
US

IV. Provider business mailing address

2506 PRINCE ST
GEORGETOWN SC
29440-2930
US

V. Phone/Fax

Practice location:
  • Phone: 843-240-4815
  • Fax:
Mailing address:
  • Phone: 843-240-4815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1111111
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANNETTA BROWN
Title or Position: COMMUNITY HEALTH WORKER /MEDICAL AS
Credential:
Phone: 843-240-4815