Healthcare Provider Details

I. General information

NPI: 1952782252
Provider Name (Legal Business Name): GREATER HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 LAKE CONCORD RD NE
CONCORD NC
28025-2926
US

IV. Provider business mailing address

528 LAKE CONCORD RD NE
CONCORD NC
28025-2926
US

V. Phone/Fax

Practice location:
  • Phone: 704-956-2478
  • Fax: 866-506-2432
Mailing address:
  • Phone: 704-956-2478
  • Fax: 866-506-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MIJE IJEOMA NWANGWU
Title or Position: DIRECTOR
Credential: BSN, MT (ASCP)
Phone: 704-577-6600