Provider Demographics
NPI:1518107739
Name:STATEWIDE NURSING SOLUTIONS LLC
Entity Type:Organization
Organization Name:STATEWIDE NURSING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-438-6942
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-0460
Mailing Address - Country:US
Mailing Address - Phone:803-438-6942
Mailing Address - Fax:
Practice Address - Street 1:728B DEWITT DR
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078-9069
Practice Address - Country:US
Practice Address - Phone:803-438-6942
Practice Address - Fax:803-408-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251B00000X, 251J00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health