Healthcare Provider Details

I. General information

NPI: 1902363286
Provider Name (Legal Business Name): TBH HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 BRIAR CIR APT D
FAYETTEVILLE NC
28306-4940
US

IV. Provider business mailing address

4 BRIAR CIR APT D
FAYETTEVILLE NC
28306-4940
US

V. Phone/Fax

Practice location:
  • Phone: 910-527-8662
  • Fax:
Mailing address:
  • Phone: 910-527-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. TYLEHYA THOMAS
Title or Position: OWNER
Credential:
Phone: 910-527-8662