Healthcare Provider Details

I. General information

NPI: 1053394775
Provider Name (Legal Business Name): TWIN STATE HOME HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 S MAIN ST
TABOR CITY NC
28463-1904
US

IV. Provider business mailing address

218 S MAIN ST
TABOR CITY NC
28463-1904
US

V. Phone/Fax

Practice location:
  • Phone: 910-653-3136
  • Fax: 910-653-5517
Mailing address:
  • Phone: 910-653-3136
  • Fax: 910-653-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. STERLING G KOONCE
Title or Position: PRESIDENT OWNER
Credential:
Phone: 910-653-3136