Individual
TASHA DAMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 58TH AVE N, NORTH MYRTLE BEACH, SC 29582-1122
(843) 446-0516
Mailing address
PO BOX 64, NORTH MYRTLE BEACH, SC 29597-0064
(843) 446-8940
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
IHCP-0978
SC
374U00000X
Home Health Aide
Primary
IHCP-0978
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHCP-0978
SC DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
SC
Enumeration date
08/07/2020
Last updated
05/10/2023
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