Provider Demographics
NPI:1871995902
Name:KOGER HOME CARE
Entity type:Organization
Organization Name:KOGER HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME CARE OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAIDIS
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:KOGER-BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:803-794-9740
Mailing Address - Street 1:1625 CHARLESTON HWY
Mailing Address - Street 2:SUITE C 2ND FLOOR
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-5049
Mailing Address - Country:US
Mailing Address - Phone:803-794-9740
Mailing Address - Fax:
Practice Address - Street 1:1625 CHARLESTON HWY
Practice Address - Street 2:SUITE C 2ND FLOOR
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-5049
Practice Address - Country:US
Practice Address - Phone:803-794-9740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care