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Organization
5 STAR HOME CARE INC
Active
Organization
5 STAR HOME CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT IVATOROV (PRESIDENT)
(843) 633-3333
Entity
Organization
Contact information
Practice address
4703 HIGHWAY 17 BYP S, MYRTLE BEACH, SC 29577-6693
(843) 633-3333
(843) 294-0140
Mailing address
4703 HIGHWAY 17 BYP S STE B, MYRTLE BEACH, SC 29577-6693
(843) 633-3333
(843) 294-0140
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
PENDING
SC
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX1712
—
SC
Enumeration date
08/11/2017
Last updated
04/26/2023
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