Healthcare Provider Details

I. General information

NPI: 1295028181
Provider Name (Legal Business Name): DAVIS QUALITY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4504 NESTWOOD ST
LADSON SC
29456-3727
US

IV. Provider business mailing address

4504 NESTWOOD ST
LADSON SC
29456-3727
US

V. Phone/Fax

Practice location:
  • Phone: 843-832-9421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateSC

VIII. Authorized Official

Name: MRS. JULIA DAVIS
Title or Position: OWNER
Credential:
Phone: 843-832-9421