Provider Demographics
NPI:1750735775
Name:EAST COAST NURSING SERVICES, LLC
Entity type:Organization
Organization Name:EAST COAST NURSING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:SCHMIDT
Authorized Official - Last Name:RUSHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-488-2493
Mailing Address - Street 1:1415 3RD AVE
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-5049
Mailing Address - Country:US
Mailing Address - Phone:843-488-2493
Mailing Address - Fax:843-488-2494
Practice Address - Street 1:1415 3RD AVE
Practice Address - Street 2:SUITE 102A
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-5049
Practice Address - Country:US
Practice Address - Phone:843-488-2493
Practice Address - Fax:843-488-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1259Medicaid