MEDICARE: DAHYOJENDAYI L FULLWOOD

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	372600000X	Adult Companion	IHCP-1297	SC
2	373H00000X	Day Training/Habilitation Specialist	IHCP-1297	SC
3	374U00000X	Home Health Aide	IHCP-1297	SC
4	376K00000X	Nurse's Aide	IHCP-1297	SC
5	385H00000X	Respite Care	IHCP-1297	SC
6	253Z00000X	In Home Supportive Care Agency	IHCP-1297	SC

General Provider Information

NPI Number	:	1669086112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAHYOJENDAYI L FULLWOOD

Provider Business Mailing Address
First Line	:	7620 RIVERS AVE
Second Line	:	SUITE 370 PMB#155
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-5008
Country	:	US
Telephone Number	:	866-491-1636
Fax Number	:	843-737-4896

Provider Business Practice Location Address
First Line	:	3236 LANDMARK DR STE 121
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-8490
Country	:	US
Telephone Number	:	866-491-1636
Fax Number	:	843-737-4896

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

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	09/02/2020

Similar Medicare Providers

1568050037 — HUMBLE BEGINNINGS HOME CARE LLC
Practice Location Address:

3236 LANDMARK DR STE 105
NORTH CHARLESTON, SC
29418-8490

Practice Phone: 843-998-7271
Practice Fax: 843-793-2603

1033041652 — NOVA HELIX MULTI CLINIC LLC
Practice Location Address:

3236 LANDMARK DR STE 110
NORTH CHARLESTON, SC
29418-8490

Practice Phone: 843-290-4885
Practice Fax: 843-793-2603

1962975904 — TAMMY L SMITH LPN
Practice Location Address:

3236 LANDMARK DR STE 105
NORTH CHARLESTON, SC
29418-8490

Practice Phone: 843-371-4728
Practice Fax: 843-793-3621

1811460033 — HEAVENLY HEART HOME CARE LLC
Practice Location Address:

3236 LANDMARK DR STE 105
NORTH CHARLESTON, SC
29418-8490

Practice Phone: 843-371-4728
Practice Fax: 843-793-3621

1912618802 — ARMSTRONG LOVING HOMECARE LLC
Practice Location Address:

3236 LANDMARK DR STE 114
NORTH CHARLESTON, SC
29418-8490

Practice Phone: 843-597-9903
Practice Fax:

1447949839 — HERE FOR YOU HOME HEALTHCARE
Practice Location Address:

3236 LANDMARK DR STE 121
NORTH CHARLESTON, SC
29418-8490

Practice Phone: 843-425-7482
Practice Fax:

Directions to “ DAHYOJENDAYI L FULLWOOD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.