Healthcare Provider Details

I. General information

NPI: 1528782570
Provider Name (Legal Business Name): NEW ESTUARY HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15919 US HIGHWAY 17 STE D
HAMPSTEAD NC
28443-3748
US

IV. Provider business mailing address

15919 US HIGHWAY 17 STE D
HAMPSTEAD NC
28443-3748
US

V. Phone/Fax

Practice location:
  • Phone: 910-541-1160
  • Fax: 910-541-1160
Mailing address:
  • Phone: 910-541-1160
  • Fax: 910-541-1160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. JESSICA PUTTBACH
Title or Position: OWNER
Credential:
Phone: 910-541-1160