Organization
VNA OF GREATER BAMBERG, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAVY RUDOLPH GWALTNEY III (CFO)
(803) 245-5611
Entity
Organization
Contact information
Practice address
923 MIDWAY ST, BAMBERG, SC 29003-1957
(803) 245-5611
(803) 245-3259
Mailing address
923 MIDWAY ST, PO BOX 1048, BAMBERG, SC 29003-1957
(803) 245-5611
(803) 245-3259
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA-045
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427030
—
SC
Enumeration date
01/03/2007
Last updated
02/04/2010
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