Provider Demographics
NPI:1073374849
Name:PROFESSIONAL WAY HEALTHCARE STAFFING, LLC
Entity Type:Organization
Organization Name:PROFESSIONAL WAY HEALTHCARE STAFFING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRIECE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-616-7805
Mailing Address - Street 1:3453 CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29540-8855
Mailing Address - Country:US
Mailing Address - Phone:843-616-7805
Mailing Address - Fax:
Practice Address - Street 1:1517 E BOBO NEWSOM HWY UNIT G
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-6269
Practice Address - Country:US
Practice Address - Phone:843-616-7805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty