Provider Demographics
NPI:1447238225
Name:PRIORITY ONE HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:PRIORITY ONE HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:LONG
Authorized Official - Last Name:SPEIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-439-2493
Mailing Address - Street 1:533 CHERAW ST
Mailing Address - Street 2:PO BOX 946
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-2841
Mailing Address - Country:US
Mailing Address - Phone:843-479-2597
Mailing Address - Fax:843-479-5570
Practice Address - Street 1:533 CHERAW ST
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-2841
Practice Address - Country:US
Practice Address - Phone:843-479-2597
Practice Address - Fax:843-479-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0683Medicaid