Provider Demographics
NPI:1982652756
Name:COLUMBIAADULT CARE INC.
Entity Type:Organization
Organization Name:COLUMBIAADULT CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:QUARLES
Authorized Official - Suffix:
Authorized Official - Credentials:BSRN
Authorized Official - Phone:803-771-7108
Mailing Address - Street 1:3127 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-3434
Mailing Address - Country:US
Mailing Address - Phone:803-771-7108
Mailing Address - Fax:803-771-7108
Practice Address - Street 1:3127 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-3434
Practice Address - Country:US
Practice Address - Phone:803-771-7108
Practice Address - Fax:803-771-7108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCADC019261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0409Medicaid