Healthcare Provider Details

I. General information

NPI: 1700668605
Provider Name (Legal Business Name): TRUSTED HEARTS HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 SUNSET AVE STE 201D
ROCKY MOUNT NC
27804-4300
US

IV. Provider business mailing address

1701 SUNSET AVE STE 201D
ROCKY MOUNT NC
27804-4300
US

V. Phone/Fax

Practice location:
  • Phone: 252-452-1999
  • Fax:
Mailing address:
  • Phone: 252-452-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHAVON A VICK
Title or Position: OWNER/CEO
Credential:
Phone: 252-220-2549