Organization
PRESTIGE HOME SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALMEDA MYERS GRAHAM R.N. B.S.N. (OWNER)
(843) 669-4664
Entity
Organization
Contact information
Practice address
1922 E MCIVER RD, FLORENCE, SC 29501-9640
(843) 669-4664
(843) 669-9229
Mailing address
1922 E MCIVER RD, FLORENCE, SC 29501-9640
(843) 669-4664
(843) 669-9229
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE2391
MEDICAID DME
SC
05
—
EX0574
—
SC
Enumeration date
01/24/2008
Last updated
01/24/2008
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