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General NPI Number Information
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NPI Number | 1174250716
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Entity Type | Organization
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Legal Business Name | SHORTER ENTERPRISES, INC.
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1200 WOODRUFF RD BLDG A3 STE 194
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City | GREENVILLE
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State | SC
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Zip | 29607
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Country | US
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Telephone | 864-203-0500
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Fax | 864-203-0888
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Provider Business Mailing Address
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Address Line | 1200 WOODRUFF RD BLDG A3 STE 194
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City | GREENVILLE
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State | SC
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Zip | 29607
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Country | US
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Telephone | 864-203-0500
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Fax | 864-203-0888
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN OWEN SHORTER
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Credential |
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Telephone | 225-235-3773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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