MEDICARE: PERNELL FAMILY SERVICES 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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1053127811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERNELL FAMILY SERVICES LLC

Provider Business Mailing Address
First Line	:	106 W CALHOUN ST
Second Line	:
City	:	DILLON
State	:	SC
Zip	:	29536-4014
Country	:	US
Telephone Number	:	843-627-3121
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 W CALHOUN ST
Second Line	:
City	:	DILLON
State	:	SC
Zip	:	29536-4014
Country	:	US
Telephone Number	:	843-627-3121
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TERESA YVETTE PERNELL
Credential	:
Telephone Number	:	843-627-3121

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	12/06/2024

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Directions to “PERNELL FAMILY SERVICES LLC ” Practice Location

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