Provider Demographics
NPI:1356398911
Name:PERSONAL CARE PLUS
Entity type:Organization
Organization Name:PERSONAL CARE PLUS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MED
Authorized Official - Phone:803-794-4060
Mailing Address - Street 1:108 INVIEW ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169
Mailing Address - Country:US
Mailing Address - Phone:803-794-4060
Mailing Address - Fax:803-794-4077
Practice Address - Street 1:108 INVIEW ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169
Practice Address - Country:US
Practice Address - Phone:803-794-4060
Practice Address - Fax:803-794-4077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2278H0200X, 372600000X, 376K00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome HealthGroup - Multi-Specialty
Not Answered372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Not Answered376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Not Answered251J00000XAgenciesNursing CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0738Medicaid