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General NPI Number Information
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NPI Number | 1669480588
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Entity Type | Organization
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Legal Business Name | MEMORIAL CAREONE HOME HEALTH SERVICES INC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 23 PLANTATION PARK DR STE 503
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City | BLUFFTON
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State | SC
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Zip | 29910-6038
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Country | US
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Telephone | 843-815-8088
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Fax | 843-815-8090
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Provider Business Mailing Address
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Address Line | PO BOX 931861
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City | ATLANTA
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State | GA
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Zip | 31198-1861
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Country | US
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Telephone | 912-350-6405
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Fax | 912-350-6413
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MS. DEANNA M WILDES
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Credential | RN
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Telephone | 912-350-6559
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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 | HHA123
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License Number State | SC
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