Provider Demographics
NPI:1225132756
Name:DYNAMIC HEALTH CARE SYSTEMS, INC.
Entity Type:Organization
Organization Name:DYNAMIC HEALTH CARE SYSTEMS, INC.
Other - Org Name:DYNAMIC HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:248-379-7999
Mailing Address - Street 1:339 HEYWARD ST
Mailing Address - Street 2:SUITE - A
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-4390
Mailing Address - Country:US
Mailing Address - Phone:803-765-2247
Mailing Address - Fax:803-765-2280
Practice Address - Street 1:339 HEYWARD ST
Practice Address - Street 2:SUITE - A
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-4390
Practice Address - Country:US
Practice Address - Phone:803-765-2247
Practice Address - Fax:803-765-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42D1032607251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
421559Medicare Oscar/Certification