MEDICARE: GENTLE HEARTS HOME CARE, INC.

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	251J00000X	Nursing Care Agency		NC

General Provider Information

NPI Number	:	1679695662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE HEARTS HOME CARE, INC.

Provider Business Mailing Address
First Line	:	1034 BRIARGATE CIR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-6539
Country	:	US
Telephone Number	:	803-750-6200
Fax Number	:	803-750-2355

Provider Business Practice Location Address
First Line	:	1034 BRIARGATE CIR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-6539
Country	:	US
Telephone Number	:	803-750-6200
Fax Number	:	803-750-2355

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. SIRCHANNIE WILLIAM SHEFFIELD
Credential	:
Telephone Number	:	803-750-6200

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	04/06/2011

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