Eddie D Isham

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

191 Issued in SC

Legal business name

EDDIE D ISHAM

Doing business as

Alonjay Adult Daycare

Practice address

567 Patterson St
Allendale, SC 29810-6027

Phone

(803) 584-1333

Fax

(803) 584-7001

NPI assigned

Feb 26, 2008

Last updated

Jul 1, 2008By 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

Mr. Eddie Dean Isham Sr.

Title

Co-Owner

Phone

(803) 584-1333

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ALONJAY ADULT DAYCARE Doing business as

Locations

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1649449406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 PATTERSON ST",
            "city": "ALLENDALE",
            "state": "SC",
            "postal_code": "298106027",
            "telephone_number": "803-584-1333",
            "fax_number": "803-584-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 PATTERSON ST",
            "city": "ALLENDALE",
            "state": "SC",
            "postal_code": "298106027",
            "telephone_number": "803-584-1333",
            "fax_number": "803-584-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDDIE D ISHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "ISHAM",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "803-584-1333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "SC",
            "license": "191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EX0623",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALONJAY ADULT DAYCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Day Care Clinic/Center in Allendale, SC
• Providers in Allendale, SC by specialty
• Adult Day Care Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; 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.