Provider Demographics
NPI:1811296130
Name:JR HOME HEALTH AGENCY, INC
Entity type:Organization
Organization Name:JR HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-763-6926
Mailing Address - Street 1:17 TECHNOLOGY CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-9591
Mailing Address - Country:US
Mailing Address - Phone:803-763-6926
Mailing Address - Fax:803-763-2030
Practice Address - Street 1:17 TECHNOLOGY CIR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-9591
Practice Address - Country:US
Practice Address - Phone:803-763-6926
Practice Address - Fax:803-763-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based