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NPI Code Detail

MEDICARE: ADDUS HEALTHCARE (SOUTH CAROLINA), INC.

MEDICARE: ADDUS HEALTHCARE (SOUTH CAROLINA), 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1841628146
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADDUS HEALTHCARE (SOUTH CAROLINA), INC.
Provider Business Mailing Address
First Line : 2300 WARRENVILLE RD
Second Line : SUITE 100
City : DOWNERS GROVE
State : IL
Zip : 60515-1765
Country : US
Telephone Number : 630-296-3400
Fax Number : 630-487-2713
Provider Business Practice Location Address
First Line : 2811 W MARKET ST
Second Line : SUITE 2
City : JOHNSON CITY
State : TN
Zip : 37604-5127
Country : US
Telephone Number : 423-926-5600
Fax Number : 423-434-0378
Authorized Official
Title or Position : NATIONAL CONTRACTS
Name : MS. DIANE KUMARICH
Credential : RN, MS, MBA
Telephone Number : 630-296-3400
Provider Enumeration Date : 10/23/2013
Last Update Date : 05/27/2014

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