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General NPI Number Information
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NPI Number | 1598167975
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Entity Type | Organization
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Legal Business Name | AJM HOMECARE SERVICES
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 112 N 1ST AVE
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City | DILLON
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State | SC
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Zip | 29536-3428
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Country | US
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Telephone | 843-627-3482
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Fax | 843-627-3560
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Provider Business Mailing Address
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Address Line | 902 WEST ST
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City | DILLON
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State | SC
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Zip | 29536-3953
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Country | US
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Telephone | 843-627-3482
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Fax | 843-627-3560
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Authorized Official
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Title or Position | OWNER
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Name | NELZARIE INEZ WYNN
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Credential |
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Telephone | 864-386-7945
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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 | EX1084
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License Number State | SC
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