MEDICARE: WHALEY COMPASSIONATE CAREGIVERS

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	374U00000X	Home Health Aide
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1881439982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHALEY COMPASSIONATE CAREGIVERS

Provider Business Mailing Address
First Line	:	1509 LADY ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3401
Country	:	US
Telephone Number	:	803-271-5401
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 LADY ST STE G
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-3401
Country	:	US
Telephone Number	:	803-271-5401
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FRANKIE DENISE MCDUFFIE
Credential	:
Telephone Number	:	803-271-5401

Provider Enumeration Date	:	06/28/2024
Last Update Date	:	06/28/2024

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