Provider Demographics
NPI:1174810758
Name:AJM HOMECARE SERVICES
Entity type:Organization
Organization Name:AJM HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:NELZARIE
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:843-627-3925
Mailing Address - Street 1:305 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-3551
Mailing Address - Country:US
Mailing Address - Phone:843-627-3925
Mailing Address - Fax:843-627-3925
Practice Address - Street 1:305 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-3551
Practice Address - Country:US
Practice Address - Phone:843-627-3925
Practice Address - Fax:843-627-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health