Healthcare Provider Details

I. General information

NPI: 1548696743
Provider Name (Legal Business Name): HOME ALONE HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2013
Last Update Date: 07/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 S PLEASANTBURG DR STE 2D
GREENVILLE SC
29607-2450
US

IV. Provider business mailing address

880 S PLEASANTBURG DR, BLDG 2-D, SUITE 1
GREENVILLE SC
29607-2450
US

V. Phone/Fax

Practice location:
  • Phone: 864-293-7479
  • Fax: 864-232-9016
Mailing address:
  • Phone: 864-293-7479
  • Fax: 864-232-9016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number008393
License Number StateSC

VIII. Authorized Official

Name: MS. HIWOT PAULOS
Title or Position: OWNER
Credential:
Phone: 864-293-7479