Healthcare Provider Details

I. General information

NPI: 1235291261
Provider Name (Legal Business Name): ELDERCARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8815 UNIVERSITY EAST DR STE 110
CHARLOTTE NC
28213-4100
US

IV. Provider business mailing address

512 KLUMAC RD STE 9
SALISBURY NC
28144-6752
US

V. Phone/Fax

Practice location:
  • Phone: 704-630-0370
  • Fax: 704-630-0788
Mailing address:
  • Phone: 704-630-0370
  • Fax: 704-630-0788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC2488
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC2488
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6601061
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 2
Identifier3408033
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer
# 3
Identifier6601062
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: LORI EBERLY
Title or Position: OWNER
Credential: MHA
Phone: 704-433-7554