MEDICARE: JENNIFER ADAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	374U00000X	Home Health Aide
2	171M00000X	Case Manager/Care Coordinator
3	172V00000X	Community Health Worker
4	332U00000X	Home Delivered Meals

General Provider Information

NPI Number	:	1558193540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ADAMS

Provider Business Mailing Address
First Line	:	1255 HORSEHEAD RD
Second Line	:
City	:	LUGOFF
State	:	SC
Zip	:	29078-9724
Country	:	US
Telephone Number	:	803-427-4721
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 HORSEHEAD RD
Second Line	:
City	:	LUGOFF
State	:	SC
Zip	:	29078-9724
Country	:	US
Telephone Number	:	803-427-4721
Fax Number	:

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

Provider Enumeration Date	:	08/17/2024
Last Update Date	:	01/12/2026

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