Healthcare Provider Details

I. General information

NPI: 1780470831
Provider Name (Legal Business Name): TANDEM HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 PINE KNOLL DR STE J2
GREENVILLE SC
29609-3251
US

IV. Provider business mailing address

117 W LONG CREEK CT
SIMPSONVILLE SC
29680-6222
US

V. Phone/Fax

Practice location:
  • Phone: 864-884-5678
  • Fax:
Mailing address:
  • Phone: 803-374-6934
  • Fax: 803-374-6934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: DIVA M HEMPHILL
Title or Position: OWNER
Credential:
Phone: 864-884-5678