Provider Demographics
NPI:1124637038
Name:WEST GREENVILLE HOME HEALTH CARE
Entity type:Organization
Organization Name:WEST GREENVILLE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BRANCH MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:DEYTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMA
Authorized Official - Phone:601-812-8361
Mailing Address - Street 1:302 BALD EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-4270
Mailing Address - Country:US
Mailing Address - Phone:601-812-8361
Mailing Address - Fax:
Practice Address - Street 1:714 S PENDLETON ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3526
Practice Address - Country:US
Practice Address - Phone:601-812-8361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health