MEDICARE: RBG AGENCY 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1144938143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RBG AGENCY LLC

Provider Business Mailing Address
First Line	:	1156 BOWMAN RD UNIT 200
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3858
Country	:	US
Telephone Number	:	843-800-0123
Fax Number	:	843-800-0601

Provider Business Practice Location Address
First Line	:	1156 BOWMAN ROAD SUITE 200
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464
Country	:	US
Telephone Number	:	843-800-0123
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DON PRATT
Credential	:
Telephone Number	:	843-800-0123

Provider Enumeration Date	:	11/08/2022
Last Update Date	:	01/30/2026

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