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Contact Information

PROFESSIONAL CARE HOME HEALTH SERVI
2070 CLOVERDALE AVE
SUITE C
WINSTON-SALEM, NC27103
 Phone: 336-725-0755
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for PROFESSIONAL CARE HOME HEALTH SERVI

NPI # 1467505305
LBN Legal business name PROFESSIONAL CARE HOME HEALTH SERVI
Authorized official TERESIA MEDLEY - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/22/2007
Last updated 06/25/2008 - About 18 years ago
Identifiers
NC Medicaid 8700436
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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