Provider Demographics
NPI:1275825598
Name:OPTIMUM HOME HEALTH
Entity Type:Organization
Organization Name:OPTIMUM HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES-JETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-430-2934
Mailing Address - Street 1:PO BOX 1385
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-0029
Mailing Address - Country:US
Mailing Address - Phone:864-430-2934
Mailing Address - Fax:
Practice Address - Street 1:3190 WADE HAMPTON BLVD
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2856
Practice Address - Country:US
Practice Address - Phone:864-430-2934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health