1982696225 NPI number — INTERIM HEALTHCARE OF THE TRIAD

Table of content: (NPI 1982696225)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982696225 NPI number — INTERIM HEALTHCARE OF THE TRIAD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTERIM HEALTHCARE OF THE TRIAD
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:
1982696225
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2526 WARD BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILSON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27893-1600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-243-7808
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 BILLINGSLEY RD STE 207
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28211-3137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-372-8230
Provider Business Practice Location Address Fax Number:
704-332-6143
Provider Enumeration Date:
08/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PILKINGTON
Authorized Official First Name:
TERRI
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
252-206-7208

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC1901 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2952 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC1886 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: HC1885 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC1902 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2222 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC1903 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HHA169 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 6600715 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100387 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100468 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3407232 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3407233 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600713 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600714 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100388 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600722 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600866 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100384 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3407234 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6601256 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100385 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100386 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600712 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100551 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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