MEDICARE: FRIENDS OF THE MIDLANDS

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	:	1578828539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDS OF THE MIDLANDS

Provider Business Mailing Address
First Line	:	101 RICE BENT WAY
Second Line	:	BUILDING 6
City	:	COLUMBIA
State	:	SC
Zip	:	29229-6849
Country	:	US
Telephone Number	:	803-736-5959
Fax Number	:	803-632-7110

Provider Business Practice Location Address
First Line	:	101 RICE BENT WAY
Second Line	:	BUILDING 6
City	:	COLUMBIA
State	:	SC
Zip	:	29229-6849
Country	:	US
Telephone Number	:	803-736-5959
Fax Number	:	803-632-7110

Authorized Official
Title or Position	:	OWNER/SECRETARY
Name	:	MR. KENNETH SUMMERS
Credential	:
Telephone Number	:	803-736-5959

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	07/05/2012

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Directions to “FRIENDS OF THE MIDLANDS ” Practice Location

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