Organization
TIDELANDS HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NITIN P SHAH (PRESIDENT)
(732) 522-3724
Entity
Organization
Contact information
Practice address
829 FRONT ST STE I, GEORGETOWN, SC 29440-3564
(732) 522-3724
Mailing address
829 FRONT ST STE I, GEORGETOWN, SC 29440-3564
(732) 522-3724
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHCP-0887
DHEC
SC
Enumeration date
07/23/2018
Last updated
07/23/2018
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