1962744565 NPI number — A TOUCH OF CARE, LLC

Table of content: (NPI 1962744565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962744565 NPI number — A TOUCH OF CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A TOUCH OF CARE, LLC
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:
Provider Other Organization Name Type Code:
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:
1962744565
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1055
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE VIEW
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29563-1055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 N. MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKEVIEW
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29563-3034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-548-9303
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
DOREKO
Authorized Official Middle Name:
Authorized Official Title or Position:
AGENCY DIRECTOR
Authorized Official Telephone Number:
843-759-2009

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1303150316 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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