1922248822 NPI number — CAROLINA STAFFING & HOME HEALTH CO,INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922248822 NPI number — CAROLINA STAFFING & HOME HEALTH CO,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROLINA STAFFING & HOME HEALTH CO,INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922248822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3510 UNIVERSITY DR
Provider Second Line Business Mailing Address:
SUITE D
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27707-2658
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-881-0277
Provider Business Mailing Address Fax Number:
919-881-0278

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3214 CHARLES B ROOT WYND
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27612-5440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-881-0277
Provider Business Practice Location Address Fax Number:
919-881-0278
Provider Enumeration Date:
03/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
OJIMADU
Authorized Official First Name:
ISRAEL
Authorized Official Middle Name:
UDOCHUKWU
Authorized Official Title or Position:
ADMINISTRATOR/OWNER
Authorized Official Telephone Number:
919-881-0277

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MHL-092656 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3409683 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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