Provider Demographics
NPI:1538499728
Name:SOUTH CAROLINA HOMECARE, LLC
Entity Type:Organization
Organization Name:SOUTH CAROLINA HOMECARE, LLC
Other - Org Name:HOME HEALTH CARE OF SOUTH CAROLINA - LOW COUNTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOVEMBER
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:337-233-1307
Mailing Address - Fax:337-233-5764
Practice Address - Street 1:109 BURTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8117
Practice Address - Country:US
Practice Address - Phone:843-851-0999
Practice Address - Fax:843-851-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC427303Medicare Oscar/Certification