Healthcare Provider Details

I. General information

NPI: 1467038166
Provider Name (Legal Business Name): OPTIMUM CARE & HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 03/23/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 DAVIS ST
FAYETTEVILLE NC
28305-5355
US

IV. Provider business mailing address

PO BOX 40602
FAYETTEVILLE NC
28309-0602
US

V. Phone/Fax

Practice location:
  • Phone: 910-286-3446
  • Fax:
Mailing address:
  • Phone: 910-286-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: FELICIA MAE MCPHATTER
Title or Position: MEDICAL BILLING SPECIALIST
Credential: AAS, MOA
Phone: 910-286-3446