Healthcare Provider Details

I. General information

NPI: 1275999328
Provider Name (Legal Business Name): MSA HOME HEALTH AND HOSPICE OF NC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 PARKVIEW DR
ELIZABETH CITY NC
27909-6533
US

IV. Provider business mailing address

PO BOX 1928
LEXINGTON SC
29071-1928
US

V. Phone/Fax

Practice location:
  • Phone: 252-338-4375
  • Fax: 252-338-4386
Mailing address:
  • Phone: 803-957-0500
  • Fax: 888-342-6190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTINA M JEFFCOAT
Title or Position: VICE PRESIDENT
Credential:
Phone: 803-957-0500