NPIMap

Organization Active NPI

Eagle Nursing LLC

  • In Home Supportive Care Agency
  • Mullins, SC
National Provider Identifier
1811554686
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
EAGLE NURSING LLC
Practice address
419 N Park St
Mullins, SC 29574-2226
Phone
(843) 246-3328
NPI assigned
May 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Authorized official

Name
Elisa GibbsNPI 1912564816
Title
Owner
Phone
(843) 246-3328

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

419 N Park St
Mullins, SC 29574-2226

Mailing address

419 N Park St
Mullins, SC 29574-2226
Phone (843) 246-3328

National Provider Directory

National Provider Directory

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": "1559001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1811554686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 N PARK ST",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295742226",
            "telephone_number": "843-246-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 N PARK ST",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295742226",
            "telephone_number": "843-246-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-28",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "ELISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-246-3328"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullins, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.