Ethereal Home Medical LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ETHEREAL HOME MEDICAL LLC

Practice address

2216 W Meadowview Rd Ste 264
Greensboro, NC 27407-3406

Phone

(336) 303-2778

NPI assigned

Mar 29, 2021

Organization subpart

No

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

Authorized official

Name

Latina Williams

Title

Assistant Director

Phone

(336) 303-2778

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1386221810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 WOODBERRY LAKE DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274550944",
            "telephone_number": "336-303-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 W MEADOWVIEW RD STE 264",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274073406",
            "telephone_number": "336-303-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHEREAL HOME MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-29",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LATINA",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "336-303-2778"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "serenevhe@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2216 W Meadowview Rd Ste 264",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274073406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Summer Dey Estes, LPC
• Lily Ann Estevez
• Cristiane Bonanato Estrela
• Erica Estrella, LCSW
• Ethereal Care, LLC
• Kate Scott Ettefagh, MD
• Keivan Ettefagh, MD
• Jessica Karam Eubanks, AGNP
• Sonja R Eubanks, MS
• Susan H Eubanks, M.ED.

• In Home Supportive Care Agency in Greensboro, NC
• Providers in Greensboro, NC by specialty
• In Home Supportive Care Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.