Healthcare Provider Details

I. General information

NPI: 1861458382
Provider Name (Legal Business Name): LOW COUNTRY FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date: 07/17/2007
Reactivation Date: 04/08/2014

III. Provider practice location address

61 HICKORY HILL ROAD SUITE C
VARNVILLE SC
29944
US

IV. Provider business mailing address

POST OFFICE BOX 912
VARNVILLE SC
29944
US

V. Phone/Fax

Practice location:
  • Phone: 803-943-1099
  • Fax: 803-943-2083
Mailing address:
  • Phone: 803-943-1099
  • Fax: 803-943-2083

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELAUNDA RENAE JENKINS
Title or Position: OFFICE MANAGER
Credential: HOME CARE AGENCY
Phone: 803-943-0159