MEDICARE: FAITHFUL 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	251E00000X	Home Health Agency		SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932434172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITHFUL HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	21 SAINT MATTHEWS RD
Second Line	:
City	:	ST MATTHEWS
State	:	SC
Zip	:	29135-8400
Country	:	US
Telephone Number	:	803-655-5411
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 SAINT MATTHEWS RD
Second Line	:
City	:	ST MATTHEWS
State	:	SC
Zip	:	29135-8400
Country	:	US
Telephone Number	:	803-655-5411
Fax Number	:	803-655-5412

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BETTYE RAVENELL
Credential	:
Telephone Number	:	803-655-5411

Provider Enumeration Date	:	10/06/2009
Last Update Date	:	11/03/2020

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