Healthcare Provider Details

I. General information

NPI: 1891225900
Provider Name (Legal Business Name): PRUITTHEALTH HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2017
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 48TH AVE N STE 102
MYRTLE BEACH SC
29577-5434
US

IV. Provider business mailing address

1626 JEURGENS CT LEGAL DEPT
NORCROSS GA
30093-2219
US

V. Phone/Fax

Practice location:
  • Phone: 843-353-1152
  • Fax: 843-213-0023
Mailing address:
  • Phone: 770-279-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA-0233
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. NEIL L. PRUITT JR.
Title or Position: CHAIRMAN AND CEO
Credential:
Phone: 770-279-6200