Provider Demographics
NPI:1679631287
Name:IN-HOME HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:IN-HOME HEALTHCARE SERVICES, INC
Other - Org Name:HOME AIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:T
Authorized Official - Last Name:ETHRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-527-2752
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29442-0398
Mailing Address - Country:US
Mailing Address - Phone:843-527-2752
Mailing Address - Fax:843-545-9854
Practice Address - Street 1:1710 S FRASER STREET
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-3910
Practice Address - Country:US
Practice Address - Phone:843-527-2752
Practice Address - Fax:843-545-9854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC12115OtherVETERANS AFFAIR
SCEX0334Medicaid
SCDE1713Medicaid