Provider Demographics
NPI:1952534000
Name:WILLIAMS HOME HEALTH CARE
Entity type:Organization
Organization Name:WILLIAMS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:X
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CE0
Authorized Official - Phone:803-840-5743
Mailing Address - Street 1:1275 PEACH ORCHARD ROAD, SUITE B
Mailing Address - Street 2:1275 PEACH ORCHARD ROAD, SUITE B
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154
Mailing Address - Country:US
Mailing Address - Phone:803-494-2590
Mailing Address - Fax:803-494-8998
Practice Address - Street 1:1275 PEACH ORCHARD RD STE B
Practice Address - Street 2:1275 PEACH ORCHARD ROAD, SUITE B
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-1356
Practice Address - Country:US
Practice Address - Phone:803-494-2590
Practice Address - Fax:803-494-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11424525251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC253421441Medicaid