Provider Demographics
NPI:1912295528
Name:HOMECARE DOC, LLC
Entity type:Organization
Organization Name:HOMECARE DOC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GIL-YOUNG
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:CHAE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:864-561-3213
Mailing Address - Street 1:10 CORK DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-0973
Mailing Address - Country:US
Mailing Address - Phone:864-561-3213
Mailing Address - Fax:864-334-5152
Practice Address - Street 1:10 CORK DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-0973
Practice Address - Country:US
Practice Address - Phone:864-561-3213
Practice Address - Fax:864-334-5152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-17
Last Update Date:2011-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1125261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care