Provider Demographics
NPI:1154565372
Name:EXCEPTIONAL HEALTHCARE
Entity type:Organization
Organization Name:EXCEPTIONAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BROUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-866-2076
Mailing Address - Street 1:694 INDIAN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:RUFFIN
Mailing Address - State:SC
Mailing Address - Zip Code:29475-3806
Mailing Address - Country:US
Mailing Address - Phone:843-866-2076
Mailing Address - Fax:
Practice Address - Street 1:694 INDIAN CREEK DR
Practice Address - Street 2:
Practice Address - City:RUFFIN
Practice Address - State:SC
Practice Address - Zip Code:29475-3806
Practice Address - Country:US
Practice Address - Phone:843-866-2076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health