Provider Demographics
NPI:1124213814
Name:NOC HOME CARE LLC
Entity Type:Organization
Organization Name:NOC HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCELVEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-393-4230
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29532-3516
Mailing Address - Country:US
Mailing Address - Phone:843-383-8579
Mailing Address - Fax:843-393-7131
Practice Address - Street 1:112 ANDERSON ROAD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3335
Practice Address - Country:US
Practice Address - Phone:803-327-0909
Practice Address - Fax:803-327-7818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEN0842Medicaid