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General NPI Number Information
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NPI Number | 1356011837
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Entity Type | Individual
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Provider Name | GREGORY JOSEPH
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Gender | Male
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 454 ANDERSON RD S
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City | ROCK HILL
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State | SC
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Zip | 29730-3392
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Country | US
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Telephone | 803-230-2415
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Fax | 803-701-9131
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Provider Business Mailing Address
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Address Line | 454 ANDERSON RD S
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City | ROCK HILL
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State | SC
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Zip | 29730-3392
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Country | US
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Telephone | 803-230-2415
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Fax | 803-701-9131
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | IHCP-1558
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | IHCP-1558
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | IHCP-1558
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | IHCP-1558
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | EY1059
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License Number State | SC
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