Healthcare Provider Details

I. General information

NPI: 1689941676
Provider Name (Legal Business Name): HOME CARE MEDICAL AIDS INC OF NINETY SIX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2011
Last Update Date: 11/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 LITTLE MTN RD
NINETY SIX SC
29666
US

IV. Provider business mailing address

105 LITTLE MOUNTAIN ROAD
NINETY SIX SC
29666
US

V. Phone/Fax

Practice location:
  • Phone: 864-543-3300
  • Fax: 864-543-3301
Mailing address:
  • Phone: 864-543-3300
  • Fax: 864-543-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number1045
License Number StateSC

VIII. Authorized Official

Name: MRS. KELLEE SMITH JONES
Title or Position: CERTIFIED RESPIRATORY THERAPIST
Credential:
Phone: 864-543-3300