1942349279 NPI number — CENTRAL HOME HEALTH INC.

Table of content: (NPI 1942349279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942349279 NPI number — CENTRAL HOME HEALTH INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL HOME HEALTH 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:
1942349279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2141 EAST GEER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-794-7266
Provider Business Mailing Address Fax Number:
919-439-0222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2141 EAST GEER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-794-7266
Provider Business Practice Location Address Fax Number:
919-439-0222
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DICKENS
Authorized Official First Name:
KANISHA
Authorized Official Middle Name:
CONRAD
Authorized Official Title or Position:
OWNER/AGENCY DIRECTOR
Authorized Official Telephone Number:
919-225-0167

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC1172 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6800246 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 944279 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3408553 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 87700240 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600275 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7202537 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7701440 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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