Healthcare Provider Details

I. General information

NPI: 1417185752
Provider Name (Legal Business Name): CUDDLE CARE NURSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 1/2 EAST BROADWAY STREET
JOHNSONVILLE SC
29555-1160
US

IV. Provider business mailing address

PO BOX 1160
JOHNSONVILLE SC
29555-1160
US

V. Phone/Fax

Practice location:
  • Phone: 843-483-4213
  • Fax: 843-483-4202
Mailing address:
  • Phone: 843-483-4213
  • Fax: 843-483-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberEX0963
License Number StateSC

VIII. Authorized Official

Name: MS. SONDRA ANN CAPPS
Title or Position: PRESIDENT
Credential:
Phone: 843-483-4213