5 Star Home Care Inc
Organization Active NPI In Home Supportive Care Agency · Myrtle Beach, SC
NPI 1740705649 · NPPES record last updated Apr 26, 2023
Key facts
- NPI
- 1740705649
- Entity type
- Organization (NPI type 2)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- Legal business name
- 5 STAR HOME CARE INC
- Practice address
- 4703 Highway 17 Byp S
Myrtle Beach, SC 29577-6693 - Phone
- (843) 633-3333
- Fax
- (843) 294-0140
- NPI assigned
- Aug 11, 2017
- Organization subpart
- No
Authorized official
- Name
- Albert Ivatorov
- Title
- President
- Phone
- (843) 633-3333
National Provider Directory
Locations
4703 Highway 17 Byp S
Myrtle Beach, SC 29577
Phone (843) 633-3333
4703 Highway 17 Byp S
Ste B
Myrtle Beach, SC 29577
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | PENDING | SC | |
| In Home Supportive Care Agency | 253Z00000X | Yes |
Addresses
Primary practice location
4703 Highway 17 Byp S
Myrtle Beach, SC 29577-6693
Mailing address
4703 Highway 17 Byp S Ste B
Myrtle Beach, SC 29577-6693
Phone (843) 633-3333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EX1712 | Medicaid | SC |
Other providers in Myrtle Beach, SC
- 360 Health Care
- 501 Family Medical Center LLC
- A New Direction Counseling LLC
- ABA Supportive Care SC LLC
- Sheharyar Asif Abbasi
- Sydney Abernathy
All providers in Myrtle Beach, SC · In Home Supportive Care Agency in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.