Healthcare Provider Details

I. General information

NPI: 1588897235
Provider Name (Legal Business Name): CMI HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2009
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S OLD STATESVILLE RD SUITE 102
HUNTERSVILLE NC
28078-7803
US

IV. Provider business mailing address

112 S OLD STATESVILLE RD SUITE 102
HUNTERSVILLE NC
28078-7803
US

V. Phone/Fax

Practice location:
  • Phone: 704-274-2027
  • Fax: 704-706-9614
Mailing address:
  • Phone: 704-274-2027
  • Fax: 704-706-9614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3874
License Number StateNC

VIII. Authorized Official

Name: MR. DOUGLAS J THOMAS
Title or Position: AGENCY OWNER
Credential:
Phone: 704-274-2027