Healthcare Provider Details

I. General information

NPI: 1629221908
Provider Name (Legal Business Name): VISITING NURSE SERVICE OF DURHAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2008
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 E MAIN ST
DURHAM NC
27701-3720
US

IV. Provider business mailing address

414 E MAIN ST
DURHAM NC
27701-3720
US

V. Phone/Fax

Practice location:
  • Phone: 919-560-7700
  • Fax: 919-560-7740
Mailing address:
  • Phone: 919-560-7700
  • Fax: 919-560-7740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0237
License Number StateNC

VIII. Authorized Official

Name: VICKI D. WATKINS
Title or Position: PHN SUPERVISOR I
Credential:
Phone: 919-560-7700