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General NPI Number Information
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NPI Number | 1356905459
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Entity Type | Organization
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Legal Business Name | P&D ENTITIES OF SC, INC
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 146 E WHITE ST STE J
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City | ROCK HILL
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State | SC
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Zip | 29730-4526
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Country | US
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Telephone | 803-329-0079
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Fax | 803-329-0405
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Provider Business Mailing Address
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Address Line | 146 E WHITE ST STE J
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City | ROCK HILL
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State | SC
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Zip | 29730-4526
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Country | US
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Telephone | 803-329-0079
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Fax | 803-329-0405
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHIL DAVIDSON
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Credential |
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Telephone | 803-329-0079
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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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