Organization
STAT HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER GILLIAM RN (ADMINSTRATOR)
(864) 540-1039
Entity
Organization
Contact information
Practice address
1314 N MAIN ST, FOUNTAIN INN, SC 29644-1332
(864) 540-1039
Mailing address
201 CAROLINA POINT PKWY APT 332, GREENVILLE, SC 29607-6564
(864) 540-1039
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333300000X
Emergency Response System Companies
—
—
Other
Enumeration date
08/26/2022
Last updated
11/08/2022
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