Provider Demographics
NPI:1053194530
Name:DAWSON AND DAWSON HOME CARE LLC
Entity type:Organization
Organization Name:DAWSON AND DAWSON HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:SHONTELL
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-812-0874
Mailing Address - Street 1:69 ROBERT SMALLS PKWY STE 3F
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-4275
Mailing Address - Country:US
Mailing Address - Phone:843-379-3321
Mailing Address - Fax:
Practice Address - Street 1:69 ROBERT SMALLS PKWY STE 3F
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-4275
Practice Address - Country:US
Practice Address - Phone:843-379-3321
Practice Address - Fax:866-502-3509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1366183477OtherMEDICAL HOME AGENCY