MEDICARE: CLIFTON BROOKS

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	HC2552	NC

General Provider Information

NPI Number	:	1558741603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLIFTON BROOKS

Provider Business Mailing Address
First Line	:	1109 SUNRISE PL
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344-9442
Country	:	US
Telephone Number	:	919-200-5599
Fax Number	:

Provider Business Practice Location Address
First Line	:	1109 SUNRISE PL
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344-9442
Country	:	US
Telephone Number	:	919-200-5599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	06/04/2015

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Directions to “ CLIFTON BROOKS ” Practice Location

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