NPIMap

Organization Active NPI

Pine Havenhome Health Care Services Inc.

  • Home Health Agency
  • Kinston, NC
National Provider Identifier
1003087347
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PINE HAVENHOME HEALTH CARE SERVICES INC.
Practice address
1108 N Herritage St
Kinston, NC 28501-3834
Phone
(252) 523-1963
NPI assigned
Mar 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Lee Bernard Russell
Title
Manager
Phone
(252) 523-1963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1108 N Herritage St
Kinston, NC 28501-3834

Mailing address

1108 N Herritage St
Kinston, NC 28501-3834
Phone (252) 523-1963

Other identifiers 1

IdentifierTypeStateIssuer
6600841MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pine Haven Home Health Care Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1003087347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N HERRITAGE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013834",
            "telephone_number": "252-523-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 N HERRITAGE ST",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013834",
            "telephone_number": "252-523-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HAVENHOME HEALTH CARE SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "252-523-1963",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600841",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.