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General NPI Number Information
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NPI Number | 1467373985
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Entity Type | Organization
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Legal Business Name | CAREBUDDY UPSTATE SC LLC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 534 RIVER CROSSING DRIVE STE 505
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City | FORT MILL
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State | SC
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Zip | 29715
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Country | US
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Telephone | 704-690-1015
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Fax |
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Provider Business Mailing Address
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Address Line | 885 GOLD HILL RD
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City | FORT MILL
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State | SC
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Zip | 29708-7946
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Country | US
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Telephone | 704-690-1015
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MYRA JEVON GOOD
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Credential |
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Telephone | 704-293-4289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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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 #4
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 335G00000X
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Taxonomy Name | Medical Foods Supplier
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License Number |
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License Number State |
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