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General NPI Number Information
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NPI Number | 1669280020
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Entity Type | Individual
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Provider Name | MELODY R WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 116 E MAIN ST STE 201
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City | ROCK HILL
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State | SC
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Zip | 29730-4540
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Country | US
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Telephone | 803-920-3931
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Fax |
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Provider Business Mailing Address
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Address Line | 1969 THOREAU WAY
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City | YORK
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State | SC
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Zip | 29745-6624
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Country | US
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Telephone | 803-920-3931
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | IHCP-2290
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License Number State | SC
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