Provider Demographics
NPI:1215332614
Name:PATTERSON HOME SERVICES
Entity type:Organization
Organization Name:PATTERSON HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-620-1429
Mailing Address - Street 1:9012 MAPLE GROVE DR
Mailing Address - Street 2:1A
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8865
Mailing Address - Country:US
Mailing Address - Phone:843-620-1429
Mailing Address - Fax:
Practice Address - Street 1:9012 MAPLE GROVE DR
Practice Address - Street 2:1A
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8865
Practice Address - Country:US
Practice Address - Phone:843-620-1429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC222017374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty