Provider Demographics
NPI:1730621103
Name:CARE CONNECT OF SOUTH CAROLINA
Entity type:Organization
Organization Name:CARE CONNECT OF SOUTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:GREEN
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-243-5553
Mailing Address - Street 1:12574 STATE HIGHWAY 213
Mailing Address - Street 2:
Mailing Address - City:JENKINSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29065-9658
Mailing Address - Country:US
Mailing Address - Phone:803-243-5553
Mailing Address - Fax:
Practice Address - Street 1:12574 STATE HIGHWAY 213
Practice Address - Street 2:
Practice Address - City:JENKINSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29065-9658
Practice Address - Country:US
Practice Address - Phone:803-243-5553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care