Provider Demographics
NPI:1487995882
Name:LILLIE'S HOME HEALTH CARE
Entity type:Organization
Organization Name:LILLIE'S HOME HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-531-8522
Mailing Address - Street 1:3324 CHANNEL MARKER WAY
Mailing Address - Street 2:
Mailing Address - City:HANAHAN
Mailing Address - State:SC
Mailing Address - Zip Code:29410-4790
Mailing Address - Country:US
Mailing Address - Phone:843-531-8522
Mailing Address - Fax:
Practice Address - Street 1:3324 CHANNEL MARKER WAY
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410-4790
Practice Address - Country:US
Practice Address - Phone:843-531-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-09
Last Update Date:2013-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health