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General NPI Number Information
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NPI Number | 1003374034
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Entity Type | Organization
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Legal Business Name | PROVIDENCE HOME HEALTH
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 500 LAKESHORE PKWY
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City | ROCK HILL
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State | SC
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Zip | 29730-4273
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Country | US
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Telephone | 803-818-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 500 LAKESHORE PKWY
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City | ROCK HILL
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State | SC
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Zip | 29730-4273
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Country | US
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Telephone | 803-327-7264
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | STEVE MURDOCK
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Credential |
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Telephone | 404-405-9487
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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 |
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License Number State |
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