Provider Demographics
NPI:1063552867
Name:JOHNSON & O'DONOVAN, INC
Entity type:Organization
Organization Name:JOHNSON & O'DONOVAN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LELAND
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-462-1808
Mailing Address - Street 1:9610 TWO NOTCH RD
Mailing Address - Street 2:STE 3
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-1601
Mailing Address - Country:US
Mailing Address - Phone:803-462-1808
Mailing Address - Fax:803-462-2180
Practice Address - Street 1:9610 TWO NOTCH RD
Practice Address - Street 2:STE 3
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-1601
Practice Address - Country:US
Practice Address - Phone:803-462-1808
Practice Address - Fax:803-462-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health