Healthcare Provider Details
I. General information
NPI: 1770459794
Provider Name (Legal Business Name): TAR HEELS CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1804 NUN ST
WILMINGTON NC
28403-2136
US
IV. Provider business mailing address
1804 NUN ST
WILMINGTON NC
28403-2136
US
V. Phone/Fax
- Phone: 213-841-5583
- Fax: 213-841-5583
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174200000X |
| Taxonomy | Meals Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347C00000X |
| Taxonomy | Private Vehicle |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LILLIN
BARFIELD
Title or Position: DIRECTOR
Credential:
Phone: 213-841-5583