Healthcare Provider Details

I. General information

NPI: 1437547627
Provider Name (Legal Business Name): BLUECROSS HOME CARE & HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2014
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 HAWORTH DR STE 303
RALEIGH NC
27609-7235
US

IV. Provider business mailing address

3509 HAWORTH DR STE 303
RALEIGH NC
27609-7235
US

V. Phone/Fax

Practice location:
  • Phone: 919-247-7171
  • Fax: 919-348-4737
Mailing address:
  • Phone: 919-247-7171
  • Fax: 919-348-4737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC4706
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. NWACHUKWU CHUKWUKAIRO OKAFOR
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 919-247-7171