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General NPI Number Information
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NPI Number | 1487090940
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Entity Type | Organization
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Legal Business Name | PRECIOUSHOMECARE
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Dates
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Enumeration Date | 05/10/2013
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 123 CRESTED EAGLE DR.
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City | RIDGELAND
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State | SC
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Zip | 29936-2639
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Country | US
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Telephone | 843-717-2178
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2303 P.O.BOX2303
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City | RIDGELAND
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State | SC
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Zip | 29936-2639
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Country | US
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Telephone | 843-717-2178
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Fax |
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Authorized Official
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Title or Position | CERTIFIEDMEDICAL ASSISTANT
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Name | MS. LAHOMA SCOTT
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Credential | MEDICALASSISTANT
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Telephone | 843-717-2178
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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 | 8611
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License Number State | SC
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