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NPI Code Detail

MEDICARE: FAMILY CARE MANAGEMENT, LLC

MEDICARE: FAMILY CARE MANAGEMENT, LLC
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
1251B00000XCase Management Agency103315SC

General Provider Information

NPI Number : 1033572482
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY CARE MANAGEMENT, LLC
Provider Business Mailing Address
First Line : 716 ANDERSON ST STE C
Second Line :
City : BELTON
State : SC
Zip : 29627-2148
Country : US
Telephone Number : 864-392-1810
Fax Number : 864-392-1811
Provider Business Practice Location Address
First Line : 716 ANDERSON ST STE C
Second Line :
City : BELTON
State : SC
Zip : 29627-2148
Country : US
Telephone Number : 864-392-1810
Fax Number : 864-392-1811
Authorized Official
Title or Position : OWNER
Name : MS. CHRYSTAL LEVERN RUCKER
Credential : RN
Telephone Number : 864-392-1810
Provider Enumeration Date : 04/02/2016
Last Update Date : 04/02/2016

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Directions to “FAMILY CARE MANAGEMENT, LLC ” Practice Location

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