NPIMap

Organization Active NPI

Pelham Home Health Services, Inc.

  • Home Health Agency
  • Fayetteville, NC
National Provider Identifier
1013158369
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC1859 Issued in NC
Legal business name
PELHAM HOME HEALTH SERVICES, INC.
Practice address
949 Country Club Dr
Fayetteville, NC 28301-2907
Phone
(910) 630-6757
Fax
(910) 884-9806
NPI assigned
Mar 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Authorized official

Name
Mrs. Mildred C Wilson
Title
Director
Phone
(910) 630-6757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC1859 NC Primary

Addresses

Primary practice location

949 Country Club Dr
Fayetteville, NC 28301-2907

Mailing address

PO Box 9754
Fayetteville, NC 28311-9091
Phone (910) 630-6757

Other identifiers 1

IdentifierTypeStateIssuer
3409245MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Pelham Home Health6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1013158369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9754",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119091",
            "telephone_number": "910-630-6757",
            "fax_number": "910-884-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 COUNTRY CLUB DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283012907",
            "telephone_number": "910-630-6757",
            "fax_number": "910-884-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MILDRED",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-630-6757",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409245",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.