Provider Demographics
NPI:1386060176
Name:APRICOT HEALTHCARE AGENCY
Entity type:Organization
Organization Name:APRICOT HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELZARIE
Authorized Official - Middle Name:I
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:864-386-7945
Mailing Address - Street 1:902 WEST ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-3953
Mailing Address - Country:US
Mailing Address - Phone:864-386-7945
Mailing Address - Fax:
Practice Address - Street 1:1809 LAURENS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2910
Practice Address - Country:US
Practice Address - Phone:864-214-9009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC200686251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management