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General NPI Number Information
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NPI Number | 1386882017
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Entity Type | Organization
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Legal Business Name | ABUNDANT HOME CARE SOLUTIONS LLC
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 2611 FOREST DR SUITE 206
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City | COLUMBIA
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State | SC
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Zip | 29204-2379
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Country | US
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Telephone | 803-233-9057
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Fax | 800-886-0591
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Provider Business Mailing Address
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Address Line | 2611 FOREST DR SUITE 206
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City | COLUMBIA
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State | SC
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Zip | 29204-2379
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Country | US
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Telephone |
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Fax | 800-886-0591
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. BEVIN GERARD STUDSTILL
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Credential |
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Telephone | 803-233-9057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 0732117
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License Number State | SC
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