Healthcare Provider Details

I. General information

NPI: 1164068896
Provider Name (Legal Business Name): MARIE WEBB'S FAMILY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2019
Last Update Date: 11/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1186 JONES WHITE RD
ROPER NC
27970-9682
US

IV. Provider business mailing address

1186 JONES WHITE RD
ROPER NC
27970-9682
US

V. Phone/Fax

Practice location:
  • Phone: 919-880-7190
  • Fax: 919-481-3323
Mailing address:
  • Phone: 919-880-7190
  • Fax: 919-481-3323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: EZROE L WEBB
Title or Position: MEMBER
Credential:
Phone: 919-880-7190