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General NPI Number Information
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NPI Number | 1881204964
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Entity Type | Organization
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Legal Business Name | PANOPTIC HEALTH LLC
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 331 E MAIN ST STE 200
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City | ROCK HILL
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State | SC
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Zip | 29730-5384
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Country | US
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Telephone | 803-740-9981
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E BAY ST STE 2015
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City | CHARLESTON
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State | SC
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Zip | 29401-2633
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Country | US
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Telephone | 803-740-9981
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMIN
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Name | JESSICA MOSES
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Credential |
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Telephone | 803-740-9981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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