Organization Active NPI

Home Care Direct, LLC

  • In Home Supportive Care Agency
  • Aynor, SC
National Provider Identifier
1053928333
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HOME CARE DIRECT, LLC
Practice address
242 8TH Ave
Aynor, SC 29511-3222
Phone
(184) 335-8200
Fax
(843) 358-2007
NPI assigned
Sep 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Pamela B Wiggins, LPN
Title
Owner/Administrator
Phone
(184) 335-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

242 8TH Ave
Aynor, SC 29511-3222

Mailing address

PO Box 645
Aynor, SC 29511-0645
Phone (184) 335-8200

Other identifiers 1

IdentifierTypeStateIssuer
EX0718MedicaidSC

National Provider Directory

National Provider Directory

Locations

242 8th Ave
Aynor, SC 29511
Phone (843) 358-2005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1053928333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "AYNOR",
            "state": "SC",
            "postal_code": "295110645",
            "telephone_number": "184-335-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 8TH AVE",
            "city": "AYNOR",
            "state": "SC",
            "postal_code": "295113222",
            "telephone_number": "184-335-8200",
            "fax_number": "843-358-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME CARE DIRECT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "WIGGINS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "184-335-8200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EX0718",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aynor, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.