MEDICARE: CSRA CARE GROUP, INC

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	163WH0200X	Home Health Registered Nurse
2	253Z00000X	In Home Supportive Care Agency	IHCP-0702	SC
3	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1144756388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CSRA CARE GROUP, INC

Provider Business Mailing Address
First Line	:	2130 WOODSIDE EXECUTIVE CT
Second Line	:
City	:	AIKEN
State	:	SC
Zip	:	29803-3809
Country	:	US
Telephone Number	:	803-278-0250
Fax Number	:	803-278-0251

Provider Business Practice Location Address
First Line	:	2130 WOODSIDE EXECUTIVE CT
Second Line	:
City	:	AIKEN
State	:	SC
Zip	:	29803-3809
Country	:	US
Telephone Number	:	803-278-0250
Fax Number	:	803-278-0251

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHAN SWAFFORD
Credential	:
Telephone Number	:	803-278-0250

Provider Enumeration Date	:	05/09/2017
Last Update Date	:	04/15/2025

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