Provider Demographics
NPI:1144601006
Name:NIGHTINGALE COMMUNITY HOME CARE, LL
Entity Type:Organization
Organization Name:NIGHTINGALE COMMUNITY HOME CARE, LL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:FLUKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-621-4663
Mailing Address - Street 1:300 W BUTLER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAULDIN
Mailing Address - State:SC
Mailing Address - Zip Code:29662-2585
Mailing Address - Country:US
Mailing Address - Phone:844-621-4663
Mailing Address - Fax:864-509-1006
Practice Address - Street 1:300 W BUTLER RD
Practice Address - Street 2:SUITE B
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-2585
Practice Address - Country:US
Practice Address - Phone:844-621-4663
Practice Address - Fax:864-509-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care