| Southern Home Care Services, Inc. | |
|
1124 Sam Rittenberg Blvd Ste 8 Charleston SC 29407-3362 | |
| (502) 394-2100 | |
| Not Available |
| Full Name | Southern Home Care Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1124 Sam Rittenberg Blvd Ste 8, Charleston, South Carolina |
| Authorized Official Name and Position | Timothy Whobrey (PROVIDER ENROLLMENT) |
| Authorized Official Contact | 5026307249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Home Care Services, Inc. 805 N Whittington Pkwy Louisville KY 40222-5186 Ph: (502) 394-2100 | Southern Home Care Services, Inc. 1124 Sam Rittenberg Blvd Ste 8 Charleston SC 29407-3362 Ph: (502) 394-2100 |
| NPI Number | 1376872895 |
|---|---|
| Provider Enumeration Date | 12/11/2009 |
| Last Update Date | 02/12/2020 |
| Certification Date | 02/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376872895 | NPI | - | NPPES |
| EX0899 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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