Healthcare Provider Details

I. General information

NPI: 1598971566
Provider Name (Legal Business Name): INTERIM HEALTHCARE - MORRIS GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 BECKER DR
ROANOKE RAPIDS NC
27870-3301
US

IV. Provider business mailing address

2526 WARD BLVD
WILSON NC
27893-1600
US

V. Phone/Fax

Practice location:
  • Phone: 252-537-1500
  • Fax: 252-537-3348
Mailing address:
  • Phone: 252-243-7808
  • Fax: 252-243-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0326
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier7100303
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: TERRI PILKINGTON
Title or Position: CFO
Credential:
Phone: 252-243-7808