Healthcare Provider Details

I. General information

NPI: 1174753081
Provider Name (Legal Business Name): ATLANTIC NURSING STAFF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 07/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SOUTH MAIN ST
LITTLETON NC
27850-1143
US

IV. Provider business mailing address

PO BOX 1143
LITTLETON NC
27850-1143
US

V. Phone/Fax

Practice location:
  • Phone: 252-586-0100
  • Fax: 252-586-0121
Mailing address:
  • Phone: 252-586-0100
  • Fax: 252-586-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3849
License Number StateNC

VIII. Authorized Official

Name: TRAVIS RON HOWARD
Title or Position: CEO
Credential:
Phone: 252-586-0100