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General NPI Number Information
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NPI Number | 1376164095
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Entity Type | Organization
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Legal Business Name | J.R. HEALTHCARE LLC
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 101 RICE BENT WAY STE 2B
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City | COLUMBIA
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State | SC
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Zip | 29229-6850
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Country | US
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Telephone | 803-832-2141
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Fax |
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Provider Business Mailing Address
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Address Line | 259 MEADOW SPRINGS DR
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City | COLUMBIA
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State | SC
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Zip | 29229-6891
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Country | US
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Telephone | 803-832-2141
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. REBECCA MARIE WILLIAMS
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Credential | RN
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Telephone | 803-832-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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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 | 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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