MEDICARE: KAY'S HOME CARE LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1467203265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAY'S HOME CARE LLC

Provider Business Mailing Address
First Line	:	2400 SUMMIT AVE STE 107
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-5014
Country	:	US
Telephone Number	:	336-225-3832
Fax Number	:	336-234-4433

Provider Business Practice Location Address
First Line	:	2400 SUMMIT AVE STE 200B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-5014
Country	:	US
Telephone Number	:	336-225-3832
Fax Number	:	336-234-4433

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	IBRAHIM KOROMA SR.
Credential	:
Telephone Number	:	336-225-3832

Provider Enumeration Date	:	03/29/2024
Last Update Date	:	02/24/2026

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