Healthcare Provider Details

I. General information

NPI: 1164664009
Provider Name (Legal Business Name): HOME CARE PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 03/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 E MAIN ST SUITE 203
ROCK HILL SC
29730-5367
US

IV. Provider business mailing address

2502 ALBATROSS LN
MATTHEWS NC
28104-3430
US

V. Phone/Fax

Practice location:
  • Phone: 803-448-1969
  • Fax: 803-746-7748
Mailing address:
  • Phone: 803-448-1969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MARVIN STALLWORTH
Title or Position: VICE PRESIDENT
Credential:
Phone: 803-448-1969