Healthcare Provider Details

I. General information

NPI: 1952066466
Provider Name (Legal Business Name): COBB HOME HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 MEDLIN DR
CARY NC
27511-4321
US

IV. Provider business mailing address

908 MEDLIN DR
CARY NC
27511-4321
US

V. Phone/Fax

Practice location:
  • Phone: 919-337-2872
  • Fax: 919-364-4797
Mailing address:
  • Phone: 919-337-2872
  • Fax: 919-364-4797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GARY COBB
Title or Position: CEO
Credential:
Phone: 919-337-2872