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General NPI Number Information
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NPI Number | 1558300293
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Entity Type | Organization
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Legal Business Name | COMMUNITY LIFE-LINK,LLC
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 4504 E HIGHWAY 76
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City | MULLINS
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State | SC
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Zip | 29574-7261
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Country | US
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Telephone | 843-464-4307
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Fax | 866-375-0088
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Provider Business Mailing Address
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Address Line | 4504 E HIGHWAY 76
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City | MULLINS
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State | SC
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Zip | 29574-7261
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Country | US
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Telephone | 843-464-4307
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Fax | 866-375-0088
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Authorized Official
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Title or Position | CEO
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Name | MR. BERNARD GERALD
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Credential |
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Telephone | 843-464-4307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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