Active NPI
Lake City Community Day Services, Inc.
- Durable Medical Equipment & Medical Supplies
- Lake City, SC
National Provider Identifier
1982812608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- LAKE CITY COMMUNITY DAY SERVICES, INC.
- Practice address
- 411 S Blanding St
Pob517
Lake City, SC 29560-3513 - Phone
- (843) 374-8088
- Fax
- (843) 374-5388
- NPI assigned
- May 18, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Earline James
- Title
- Director/Owner
- Phone
- (843) 374-8088
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
411 S Blanding St
Pob517
Lake City, SC 29560-3513
Mailing address
PO Box 517
411 S Blanding Street
Lake City, SC 29560
Phone (843) 374-8088
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5862700001 | Medicaid | SC |
Other names 1
- Genesis I Adult Day Care Services, Inc
National Provider Directory
National Provider Directory- Tax ID family
- Genesis I Adult Day Care Services Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Health Maintenance Organization
- Lake City, SC
- NPI 1801972542
Locations
411 S Blanding St
Lake City, SC 29560
Phone (843) 374-8088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1271203200000",
"number": "1982812608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 517",
"address_2": "411 S BLANDING STREET",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "29560",
"telephone_number": "843-374-8088",
"fax_number": "843-374-5388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 S BLANDING ST",
"address_2": "POB517",
"city": "LAKE CITY",
"state": "SC",
"postal_code": "295603513",
"telephone_number": "843-374-8088",
"fax_number": "843-374-5388"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE CITY COMMUNITY DAY SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-18",
"last_updated": "2010-04-14",
"status": "A",
"authorized_official_last_name": "JAMES",
"authorized_official_first_name": "EARLINE",
"authorized_official_title_or_position": "DIRECTOR/OWNER",
"authorized_official_telephone_number": "843-374-8088",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5862700001",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Genesis I Adult Day Care Services, Inc",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lake City, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.