Healthcare Provider Details

I. General information

NPI: 1649102385
Provider Name (Legal Business Name): PLATINUM PRIVATE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 FRIAR PARK LN
LYMAN SC
29365-1257
US

IV. Provider business mailing address

537 FRIAR PARK LN
LYMAN SC
29365-1257
US

V. Phone/Fax

Practice location:
  • Phone: 864-347-0547
  • Fax:
Mailing address:
  • Phone: 864-347-0547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MISS SHANIQUA BRIANNA YATES
Title or Position: OWNER
Credential: CMA,EMT
Phone: 864-347-0547