NPIMap

Organization Active NPI

Professional Care Home Health

  • Durable Medical Equipment & Medical Supplies
  • Winston Salem, NC
National Provider Identifier
1417109877
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROFESSIONAL CARE HOME HEALTH
Practice address
2070 Cloverdale Ave
Suite C
Winston-Salem, NC 28215-5765
Phone
(336) 725-0755
NPI assigned
Oct 16, 2008
Last updated
Oct 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
Teresia Medley
Title
Administrator
Phone
(704) 536-7326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2070 Cloverdale Ave
Suite C
Winston-Salem, NC 28215-5765

Mailing address

2070 Cloverdale Ave
Suite C
Winston-Salem, NC 28215-5765
Phone (336) 725-0755

National Provider Directory

National Provider Directory
Tax ID family
Professional Care Home Health Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1417109877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 CLOVERDALE AVE",
            "address_2": "SUITE C",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "282155765",
            "telephone_number": "336-725-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 CLOVERDALE AVE",
            "address_2": "SUITE C",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "282155765",
            "telephone_number": "336-725-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL CARE HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "MEDLEY",
        "authorized_official_first_name": "TERESIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "704-536-7326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.