Tidewater Home Health, PA

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

460342 Issued in SC

Legal business name

TIDEWATER HOME HEALTH, PA

Practice address

215 Medical Cir
West Columbia, SC 29169-3653

Phone

(803) 753-7017

Fax

(803) 739-7079

NPI assigned

Apr 8, 2014

Last updated

Apr 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Guest

Title

Cfo

Phone

(803) 600-0842

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1245659127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MEDICAL CIR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693653",
            "telephone_number": "803-753-7017",
            "fax_number": "803-739-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MEDICAL CIR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693653",
            "telephone_number": "803-753-7017",
            "fax_number": "803-739-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER HOME HEALTH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-08",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "GUEST",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "803-600-0842"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "460342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Home Health Agency in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.