Organization
VITAL AGING OF WILLIAMSBURG COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY B ELDER (EXECUTIVE DIRECTOR)
(843) 354-5496
Entity
Organization
Contact information
Practice address
501 NORTH LONGSTREET STREET, KINGSTREE, SC 29556
(843) 354-5496
(854) 354-3107
Mailing address
501 NORTH LONGSTREET STREET, P.O. BOX 450, KINGSTREE, SC 29556
(843) 354-5496
(854) 354-3107
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4010
IVR PIN
SC
Enumeration date
02/21/2007
Last updated
08/22/2020
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