MEDICARE: NGL 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1942171848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NGL INC

Provider Business Mailing Address
First Line	:	652 BUSH RIVER RD STE 211
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-7537
Country	:	US
Telephone Number	:	803-400-8750
Fax Number	:

Provider Business Practice Location Address
First Line	:	652 BUSH RIVER RD STE 211
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-7537
Country	:	US
Telephone Number	:	803-400-8750
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NOLAN GRAHAM
Credential	:
Telephone Number	:	803-400-8750

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	12/15/2025

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Directions to “NGL INC ” Practice Location

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