Healthcare Provider Details

I. General information

NPI: 1477006377
Provider Name (Legal Business Name): DBRZ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 TRAVELERS BLVD SUITE A-2
SUMMERVILLE SC
29485-8476
US

IV. Provider business mailing address

801 TRAVELERS BLVD SUITE A-2
SUMMERVILLE SC
29485-8476
US

V. Phone/Fax

Practice location:
  • Phone: 843-285-5155
  • Fax:
Mailing address:
  • Phone: 843-285-5155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberIHCP-0464
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: RICHELLE COFFEY
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 843-285-5155