Provider Demographics
NPI:1538406681
Name:COMFORT CARE OF SOUTH CAROLINA
Entity type:Organization
Organization Name:COMFORT CARE OF SOUTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MCD CCC-SLP
Authorized Official - Phone:843-398-1254
Mailing Address - Street 1:2224 PALM CT
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-9420
Mailing Address - Country:US
Mailing Address - Phone:843-398-1254
Mailing Address - Fax:
Practice Address - Street 1:181 E EVANS ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2511
Practice Address - Country:US
Practice Address - Phone:843-398-1254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care