MEDICARE: VIOLA PUGH

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	172A00000X	Driver
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1487586459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIOLA PUGH

Provider Business Mailing Address
First Line	:	4853 MEADOWSWEET DR APT 1804
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-6647
Country	:	US
Telephone Number	:	843-467-9905
Fax Number	:

Provider Business Practice Location Address
First Line	:	4853 MEADOWSWEET DR APT 1804
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-6647
Country	:	US
Telephone Number	:	843-467-9905
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ VIOLA PUGH ” Practice Location

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