Provider Demographics
NPI:1518133727
Name:MIDLANDS SENIOR CARE
Entity Type:Organization
Organization Name:MIDLANDS SENIOR CARE
Other - Org Name:DIRECT LINK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUROUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-765-9096
Mailing Address - Street 1:619 CHATHAM AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-2734
Mailing Address - Country:US
Mailing Address - Phone:803-765-9096
Mailing Address - Fax:803-765-9076
Practice Address - Street 1:619 CHATHAM AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-2734
Practice Address - Country:US
Practice Address - Phone:803-765-9096
Practice Address - Fax:803-765-9076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies