Healthcare Provider Details

I. General information

NPI: 1740769348
Provider Name (Legal Business Name): SENTINEL HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 AMITY CT STE 100
CHARLOTTE NC
28215-5745
US

IV. Provider business mailing address

3141 AMITY CT STE 100
CHARLOTTE NC
28215-5745
US

V. Phone/Fax

Practice location:
  • Phone: 704-900-6122
  • Fax: 704-900-6116
Mailing address:
  • Phone: 704-900-6122
  • Fax: 704-900-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RONALD LAWSON
Title or Position: OWNER
Credential:
Phone: 704-900-6122