Provider Demographics
NPI:1376003723
Name:JENKINS HOME CARE LLC
Entity Type:Organization
Organization Name:JENKINS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYONG
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:843-637-9102
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:COTTAGEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29435-0323
Mailing Address - Country:US
Mailing Address - Phone:843-530-7594
Mailing Address - Fax:800-695-2813
Practice Address - Street 1:2178 SAVANNAH HWY STE B-8
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5311
Practice Address - Country:US
Practice Address - Phone:843-637-9102
Practice Address - Fax:800-695-2813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care