MEDICARE: SHILOH HOME CARE SERVICES LLC

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	:	1730709676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHILOH HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1 CHICK SPRINGS RD STE 214B
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-4971
Country	:	US
Telephone Number	:	864-800-2544
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CHICK SPRINGS RD STE 214B
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-4971
Country	:	US
Telephone Number	:	864-800-2544
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TEKEVIES MCCOMBS
Credential	:
Telephone Number	:	864-800-2544

Provider Enumeration Date	:	04/21/2020
Last Update Date	:	04/21/2020

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