Healthcare Provider Details

I. General information

NPI: 1245817618
Provider Name (Legal Business Name): ESSENTIALLY PREFERRED HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHICK SPRINGS RD STE 313A
GREENVILLE SC
29609-4984
US

IV. Provider business mailing address

1 CHICK SPRINGS RD STE 313A
GREENVILLE SC
29609-4984
US

V. Phone/Fax

Practice location:
  • Phone: 864-438-1660
  • Fax: 864-751-4219
Mailing address:
  • Phone: 864-438-1660
  • Fax: 864-751-4219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY GRISSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 864-438-1660