Healthcare Provider Details

I. General information

NPI: 1487586459
Provider Name (Legal Business Name): VIOLA PUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4853 MEADOWSWEET DR APT 1804
MYRTLE BEACH SC
29579-6647
US

IV. Provider business mailing address

4853 MEADOWSWEET DR APT 1804
MYRTLE BEACH SC
29579-6647
US

V. Phone/Fax

Practice location:
  • Phone: 843-467-9905
  • Fax:
Mailing address:
  • Phone: 843-467-9905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: