Provider Demographics
NPI:1245217249
Name:NOC HOME CARE, LLC
Entity Type:Organization
Organization Name:NOC HOME CARE, LLC
Other - Org Name:NURSES ON CALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:K
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:29540-1237
Mailing Address - Country:US
Mailing Address - Phone:843-393-4230
Mailing Address - Fax:843-393-7131
Practice Address - Street 1:1600 HARRY BYRD HWY
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-3516
Practice Address - Country:US
Practice Address - Phone:843-393-4230
Practice Address - Fax:843-393-7131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0526Medicaid
SCEX0739Medicaid
SCEX0640Medicaid
SCEXG054Medicaid