MEDICARE: A GREATER HOPE HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QA0600X	Adult Day Care Clinic/Center
2	311ZA0620X	Adult Care Home Facility
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1902554678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A GREATER HOPE HEALTHCARE

Provider Business Mailing Address
First Line	:	919 TRUE ST UNIT A4
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29209-1662
Country	:	US
Telephone Number	:	803-830-0529
Fax Number	:

Provider Business Practice Location Address
First Line	:	919 TRUE ST UNIT A4
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29209-1662
Country	:	US
Telephone Number	:	803-830-0529
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MALIKI PATEL
Credential	:
Telephone Number	:	803-830-0529

Provider Enumeration Date	:	03/12/2022
Last Update Date	:	03/12/2022

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Directions to “A GREATER HOPE HEALTHCARE ” Practice Location

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