Healthcare Provider Details

I. General information

NPI: 1720326788
Provider Name (Legal Business Name): COMFORT HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2013
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201B S MAIN ST # B
MC COLL SC
29570-2020
US

IV. Provider business mailing address

201B S MAIN ST # B
MC COLL SC
29570-2020
US

V. Phone/Fax

Practice location:
  • Phone: 843-523-5195
  • Fax: 843-523-9159
Mailing address:
  • Phone: 843-523-5195
  • Fax: 843-523-9159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4784
License Number StateSC

VIII. Authorized Official

Name: MRS. NICIA VICTORIA WILLIAMS
Title or Position: CEO/OWNER
Credential:
Phone: 910-850-2188