NPIMap

Organization Active NPI

Pelham Home Health Services, Inc.

Doing business as Pelham Home Health

  • Home Health Agency
  • Saint Pauls, NC
National Provider Identifier
1194966440
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC2268 Issued in NC
Legal business name
PELHAM HOME HEALTH SERVICES, INC.
Doing business as
Pelham Home Health
Practice address
315 W Broad St
Saint Pauls, NC 28384-1535
Phone
(910) 865-3368
Fax
(910) 865-3394
NPI assigned
Mar 17, 2009
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC2268 NC Primary

Addresses

Primary practice location

315 W Broad St
Saint Pauls, NC 28384-1535

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
6600905MedicaidNC

Other names 1

  • Pelham Home Health Doing business as

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.

Locations

315 W Broad St
Saint Pauls, NC 28384
Phone (910) 865-1132

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": "1237248000000",
    "number": "1194966440",
    "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": "315 W BROAD ST",
            "city": "SAINT PAULS",
            "state": "NC",
            "postal_code": "283841535",
            "telephone_number": "910-865-3368",
            "fax_number": "910-865-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM HOME HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "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.",
        "authorized_official_credential": "RNC, BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC2268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600905",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pelham Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Pauls, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.