Healthcare Provider Details

I. General information

NPI: 1306173844
Provider Name (Legal Business Name): TJS HOME CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3436 BEAMAN OLD CREEK RD
SNOW HILL NC
28580-8308
US

IV. Provider business mailing address

3436 BEAMAN OLD CREEK RD
SNOW HILL NC
28580-8308
US

V. Phone/Fax

Practice location:
  • Phone: 252-747-4304
  • Fax: 252-747-5129
Mailing address:
  • Phone: 252-747-4304
  • Fax: 252-747-5129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC4281
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: THELMA R JOHNSON
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 252-747-4304