MEDICARE: PENTRINA STEWART

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1003794512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PENTRINA STEWART

Provider Business Mailing Address
First Line	:	PO BOX 1615
Second Line	:
City	:	HOLLYWOOD
State	:	SC
Zip	:	29449-1615
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6310 HIGHWAY 162
Second Line	:
City	:	HOLLYWOOD
State	:	SC
Zip	:	29449-6711
Country	:	US
Telephone Number	:	843-331-9327
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	08/22/2025

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Directions to “ PENTRINA STEWART ” Practice Location

Language	Start Address	Practice Location

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