Healthcare Provider Details

I. General information

NPI: 1568933919
Provider Name (Legal Business Name): C&S DYNASTY WEALTH BUILDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 SAINT ANDREWS RD
IRMO SC
29063-2866
US

IV. Provider business mailing address

7801 SAINT ANDREWS RD
IRMO SC
29063-2866
US

V. Phone/Fax

Practice location:
  • Phone: 803-569-6550
  • Fax:
Mailing address:
  • Phone: 803-569-6550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: SHANNON DAVIS
Title or Position: OWNER/CEO
Credential:
Phone: 803-569-6550