MEDICARE: TRACY WARE

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	IHCP0770	SC

General Provider Information

NPI Number	:	1821508821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY WARE

Provider Business Mailing Address
First Line	:	501 W BUTLER RD STE E
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-4846
Country	:	US
Telephone Number	:	864-326-0004
Fax Number	:	800-706-2753

Provider Business Practice Location Address
First Line	:	501 W BUTLER RD STE E
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-4846
Country	:	US
Telephone Number	:	864-326-0004
Fax Number	:	800-706-2753

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

Provider Enumeration Date	:	10/04/2017
Last Update Date	:	10/04/2017

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Directions to “ TRACY WARE ” Practice Location

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