Provider Demographics
NPI:1063570265
Name:SUMTER SENIOR SERVICES, INC.
Entity type:Organization
Organization Name:SUMTER SENIOR SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAKERSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-773-5508
Mailing Address - Street 1:PO BOX 832
Mailing Address - Street 2:110 N. SALEM AVE.
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-0832
Mailing Address - Country:US
Mailing Address - Phone:803-773-5508
Mailing Address - Fax:
Practice Address - Street 1:110 N SALEM AVE
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4529
Practice Address - Country:US
Practice Address - Phone:803-773-5508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare