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General NPI Number Information
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NPI Number | 1003227331
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Entity Type | Organization
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Legal Business Name | WINYAH HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 05/08/2014
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Last Update Date | 05/08/2014
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Provider Practice Location Address
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Address Line | 172 MCSWAIN DR SUITE A
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4804
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Country | US
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Telephone | 803-771-7740
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Fax |
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Provider Business Mailing Address
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Address Line | 137 PROFESSIONAL LN SUITE C
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-8631
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Country | US
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Telephone | 843-979-7079
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Fax | 843-979-7057
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Authorized Official
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Title or Position | CHAIRMAN
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Name | GARY C. COOPER
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Credential | MHA
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Telephone | 843-979-7079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA-0220
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License Number State | SC
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