Provider Demographics
NPI:1366335309
Name:ALTRUVA HOME CARE LLC
Entity type:Organization
Organization Name:ALTRUVA HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT, ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-358-8600
Mailing Address - Street 1:9367 TWO NOTCH RD STE 124
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6442
Mailing Address - Country:US
Mailing Address - Phone:803-358-8600
Mailing Address - Fax:
Practice Address - Street 1:9367 TWO NOTCH RD STE 124
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6442
Practice Address - Country:US
Practice Address - Phone:803-358-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care