Healthcare Provider Details

I. General information

NPI: 1649090853
Provider Name (Legal Business Name): MVP HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 SAINT PAUL ST STE D
ORANGEBURG SC
29115-5465
US

IV. Provider business mailing address

396 SAINT PAUL ST STE D
ORANGEBURG SC
29115-5465
US

V. Phone/Fax

Practice location:
  • Phone: 803-809-0505
  • Fax:
Mailing address:
  • Phone: 803-809-0505
  • 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: SANDRA OLIVER
Title or Position: CEO
Credential:
Phone: 678-895-7635