Healthcare Provider Details

I. General information

NPI: 1659405900
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF THE TRIANGLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6310 CHAPEL HILL RD STE 280
RALEIGH NC
27607-4244
US

IV. Provider business mailing address

3710 UNIVERSITY DR STE 135
DURHAM NC
27707-6259
US

V. Phone/Fax

Practice location:
  • Phone: 919-420-0336
  • Fax: 919-420-0172
Mailing address:
  • Phone: 919-493-7575
  • Fax: 919-493-4054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberHC2075
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHC2075
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHC2075
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberHC2075
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA LOU BYRD
Title or Position: OWNER
Credential:
Phone: 919-420-0336