Provider Demographics
NPI:1568930485
Name:LOW COUNTRY ELDER CARE, LLC.
Entity Type:Organization
Organization Name:LOW COUNTRY ELDER CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSEN-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-628-3398
Mailing Address - Street 1:11 BEACHWOOD W
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-2817
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:359 WANDO PLACE DR STE B
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7926
Practice Address - Country:US
Practice Address - Phone:843-628-3398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care