Organization
TIDEWATER HOME HEALTH, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GUEST (CFO)
(803) 600-0842
Entity
Organization
Contact information
Practice address
215 MEDICAL CIR, WEST COLUMBIA, SC 29169-3653
(803) 753-7017
(803) 739-7079
Mailing address
215 MEDICAL CIR, WEST COLUMBIA, SC 29169-3653
(803) 753-7017
(803) 739-7079
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
460342
SC
Other
Enumeration date
04/08/2014
Last updated
04/08/2014
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