1578676896 NPI number — MERIWEATHER HOME NURSING,INC

Table of content: (NPI 1578676896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578676896 NPI number — MERIWEATHER HOME NURSING,INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MERIWEATHER HOME NURSING,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:
1578676896
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 E NORTHWOOD ST
Provider Second Line Business Mailing Address:
SUITE 112
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27401-1224
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-272-9696
Provider Business Mailing Address Fax Number:
336-272-9697

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
897 PETERS CREEK PKWY
Provider Second Line Business Practice Location Address:
SUITE104
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27103-3858
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-784-3243
Provider Business Practice Location Address Fax Number:
336-784-3355
Provider Enumeration Date:
08/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MERIWATHER
Authorized Official First Name:
FRAN
Authorized Official Middle Name:
N.
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
336-272-9696

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC2108 , 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: 6601060 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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