Healthcare Provider Details

I. General information

NPI: 1316863632
Provider Name (Legal Business Name): PK HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 SHANNON RD STE 346
DURHAM NC
27707-6330
US

IV. Provider business mailing address

902 PEBBLESTONE DR
DURHAM NC
27703-7193
US

V. Phone/Fax

Practice location:
  • Phone: 919-482-1228
  • Fax:
Mailing address:
  • Phone: 919-482-1228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PANDWE A KALALA
Title or Position: ADMINISTRATOR
Credential:
Phone: 919-482-1228