CCN: 427126 NPI: 1245659127 Organization

TIDEWATER HOME HEALTH, PA

215 MEDICAL CIR
WEST COLUMBIA, SC 291693653

Contact Information

Phone 8037537017
Fax 8037397079
Enumeration Date 2014-04-08
Last Updated 2014-04-08

Taxonomies

Code: 251E00000X (Primary) License State: SC License: 460342

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 3

cbsaActualGeographicLocation 17900

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 17900

providerType 36

specialPaymentIndicator

carrierCode 11202

localityCode 01