Healthcare Provider Details

I. General information

NPI: 1447983606
Provider Name (Legal Business Name): A-Z HOME HEALTH CARE OF NORTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 MOSBY LN
SPRING LAKE NC
28390-7120
US

IV. Provider business mailing address

PO BOX 70
SPRING LAKE NC
28390-0070
US

V. Phone/Fax

Practice location:
  • Phone: 984-269-3413
  • Fax: 910-436-0268
Mailing address:
  • Phone: 984-269-3413
  • Fax: 910-436-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. MCTISA MICHELLE LANE
Title or Position: AGENCY DIRECTOR/ CO-OWNER
Credential: DNP
Phone: 984-269-3413