1679887145 NPI number — ADDUS HEALTHCARE (SOUTH CAROLINA), INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679887145 NPI number — ADDUS HEALTHCARE (SOUTH CAROLINA), INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADDUS HEALTHCARE (SOUTH CAROLINA), INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CAREPRO HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679887145
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2401 S PLUM GROVE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALATINE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60067-7486
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-303-5300
Provider Business Mailing Address Fax Number:
847-303-5376

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 W LAUREL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29501-5216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-815-6331
Provider Business Practice Location Address Fax Number:
843-667-6771
Provider Enumeration Date:
07/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
KUMARICH
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
Authorized Official Title or Position:
NATIONAL CONTRACTS
Authorized Official Telephone Number:
847-303-5300

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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