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General NPI Number Information
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NPI Number | 1295321818
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Entity Type | Organization
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Legal Business Name | SOUTHERN HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 12/17/2020
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 125 OREGON AVE
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City | GREENWOOD
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State | SC
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Zip | 29646-2273
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Country | US
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Telephone | 803-336-1062
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Fax |
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Provider Business Mailing Address
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Address Line | 805 N WHITTINGTON PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40222-7101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT & DIRECTOR
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Name | MARGARET SHERRY PEMBERTON
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Credential |
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Telephone | 502-272-3466
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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