Provider Demographics
NPI:1487090940
Name:PRECIOUSHOMECARE
Entity type:Organization
Organization Name:PRECIOUSHOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIEDMEDICAL ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAHOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICALASSISTANT
Authorized Official - Phone:843-717-2178
Mailing Address - Street 1:PO BOX 2303
Mailing Address - Street 2:P.O.BOX2303
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-2639
Mailing Address - Country:US
Mailing Address - Phone:843-717-2178
Mailing Address - Fax:
Practice Address - Street 1:123 CRESTED EAGLE DR.
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-2639
Practice Address - Country:US
Practice Address - Phone:843-717-2178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8611251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health