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General NPI Number Information
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NPI Number | 1962547406
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Entity Type | Organization
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Legal Business Name | ADDUS HEALTHCARE (SOUTH CAROLINA), INC.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 56 BOONE TRL
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-3515
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Country | US
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Telephone | 336-667-2208
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Fax |
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Provider Business Mailing Address
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Address Line | 801 WARRENVILLE RD STE 800
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City | LISLE
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State | IL
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Zip | 60532-0912
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Country | US
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Telephone | 630-296-3400
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Fax | 630-487-2713
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Authorized Official
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Title or Position | EVP CGRO
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Name | DARBY ANDERSON
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Credential |
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Telephone | 630-296-3443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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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 | 171WV0202X
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Taxonomy Name | Vehicle Modifications Contractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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