Providence Home Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PROVIDENCE HOME CARE LLC

Practice address

128 Millport Cir
Suite 200
Greenville, SC 29607-5571

Phone

(864) 252-9022

NPI assigned

Jun 3, 2013

Organization subpart

No

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

Authorized official

Name

Gerthia McCullough

Title

Owner

Phone

(864) 252-9022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1255778064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MILLPORT CIR",
            "address_2": "SUITE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MILLPORT CIR",
            "address_2": "SUITE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075571",
            "telephone_number": "864-252-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "GERTHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-252-9022"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Greenville, SC
• Providers in Greenville, SC by specialty
• Skilled Nursing Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.