Provider Demographics
NPI:1003294851
Name:ELITE HOME CARE
Entity Type:Organization
Organization Name:ELITE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-869-8730
Mailing Address - Street 1:PO BOX 1181
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-1181
Mailing Address - Country:US
Mailing Address - Phone:864-869-8739
Mailing Address - Fax:704-919-5011
Practice Address - Street 1:2000 BUD ARTHUR BRIDGE RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-4417
Practice Address - Country:US
Practice Address - Phone:864-580-6477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0030253Z00000X
261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1828OtherLAURENS
SCEN1788OtherGREER
SCEY1000OtherLIBERTY
SCEX1348OtherLEGACY
SCEY1008OtherGREENWOOD