Provider Demographics
NPI:1992762512
Name:NEW BEGINNINGS DIABETIC & HOMECARE SERVICES, INC
Entity type:Organization
Organization Name:NEW BEGINNINGS DIABETIC & HOMECARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENDA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:JARVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-531-3339
Mailing Address - Street 1:1300 GLEN GLORIA ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-2538
Mailing Address - Country:US
Mailing Address - Phone:803-531-3339
Mailing Address - Fax:803-531-3069
Practice Address - Street 1:1300 GLEN GLORIA ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2538
Practice Address - Country:US
Practice Address - Phone:803-531-3339
Practice Address - Fax:803-531-3069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDE1928251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE1928Medicaid
SCDPE042Medicaid
SCEX0606Medicaid
SCDPE042Medicaid
SCDE1928Medicaid