Provider Demographics
NPI:1689668428
Name:HOME HEALTH COMPANION SERVICES OF SOUTH CAROLINA INC
Entity Type:Organization
Organization Name:HOME HEALTH COMPANION SERVICES OF SOUTH CAROLINA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:CHISHOLM
Authorized Official - Suffix:
Authorized Official - Credentials:CEO/COO
Authorized Official - Phone:843-679-7060
Mailing Address - Street 1:PO BOX 5599
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-5599
Mailing Address - Country:US
Mailing Address - Phone:843-679-7060
Mailing Address - Fax:843-679-7073
Practice Address - Street 1:1668 HERLONG CT
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1183
Practice Address - Country:US
Practice Address - Phone:803-325-1455
Practice Address - Fax:803-325-2192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAR0010Medicaid
SC426604Medicare ID - Type Unspecified