Provider Demographics
NPI:1902203615
Name:SC NURSING SERVICES LLC
Entity Type:Organization
Organization Name:SC NURSING SERVICES LLC
Other - Org Name:INTERIM HEALTHCARE - MYRTLE BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-201-8303
Mailing Address - Street 1:1297 PROFESSIONAL DRIVE SUITE 201-C3
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577
Mailing Address - Country:US
Mailing Address - Phone:843-839-9349
Mailing Address - Fax:
Practice Address - Street 1:1297 PROFESSIONAL DRIVE
Practice Address - Street 2:SUITE 201 C3
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577
Practice Address - Country:US
Practice Address - Phone:843-839-9349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care