Provider Demographics
NPI:1316749617
Name:SOUTH CAROLINA SENIOR CARE ADVISORS
Entity type:Organization
Organization Name:SOUTH CAROLINA SENIOR CARE ADVISORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:NOVELLA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-878-2478
Mailing Address - Street 1:3450 MAIN HWY
Mailing Address - Street 2:
Mailing Address - City:BAMBERG
Mailing Address - State:SC
Mailing Address - Zip Code:29003-1865
Mailing Address - Country:US
Mailing Address - Phone:803-245-8330
Mailing Address - Fax:844-375-1125
Practice Address - Street 1:3450 MAIN HWY
Practice Address - Street 2:
Practice Address - City:BAMBERG
Practice Address - State:SC
Practice Address - Zip Code:29003-1865
Practice Address - Country:US
Practice Address - Phone:803-245-8330
Practice Address - Fax:844-375-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No305S00000XManaged Care OrganizationsPoint of Service