MEDICARE: A-Z HOME HEALTH CARE OF NORTH CAROLINA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1447983606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-Z HOME HEALTH CARE OF NORTH CAROLINA

Provider Business Mailing Address
First Line	:	PO BOX 70
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-0070
Country	:	US
Telephone Number	:	984-269-3413
Fax Number	:	910-436-0268

Provider Business Practice Location Address
First Line	:	88 MOSBY LN
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-7120
Country	:	US
Telephone Number	:	984-269-3413
Fax Number	:	910-436-0268

Authorized Official
Title or Position	:	AGENCY DIRECTOR/ CO-OWNER
Name	:	DR. MCTISA MICHELLE LANE
Credential	:	DNP
Telephone Number	:	984-269-3413

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	07/06/2022

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