Healthcare Provider Details

I. General information

NPI: 1841110889
Provider Name (Legal Business Name): SOUTHERN HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2965 COLONNADE DR STE 130
ROANOKE VA
24018-3541
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-5186
US

V. Phone/Fax

Practice location:
  • Phone: 423-787-7717
  • Fax:
Mailing address:
  • Phone:
  • 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: MARGARET PEMBERTON
Title or Position: VP AND MANAGER
Credential:
Phone: 502-394-2100