NPI 1093516163
Klassic Black Enterprise LLC
Practice location
- Address
- 698 Bultman Dr Unit L, Sumter, SC 29150-2549
- Phone
- (803) 464-3424
- Mailing address
- 937 Mordred St, Sumter, SC 29154-7407
Authorised official
- Name
- Victoria Clonmell
- Title
- Owner
- Phone
- (803) 464-3424
Registered specialties (2)
In Home Supportive Care Agency
Primary
Home Health Agency
Registry record
- NPI
- 1093516163
- Entity type
- Organization
- NPI issued
- 24 Mar 2025
- Record last updated
- 20 Jun 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.