Healthcare Provider Details

I. General information

NPI: 1528274214
Provider Name (Legal Business Name): INTERIM HEALTHCARE - MORRIS GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2526 WARD BLVD
WILSON NC
27893-1600
US

IV. Provider business mailing address

2526 WARD BLVD
WILSON NC
27893-1600
US

V. Phone/Fax

Practice location:
  • Phone: 252-243-7808
  • Fax: 252-243-7385
Mailing address:
  • Phone: 252-243-7808
  • Fax: 252-243-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0267
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0269
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0293
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0025
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0326
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1019
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC0333
License Number StateNC
# 8
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1703
License Number StateNC

VII. Legacy identifiers

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

# 1
Identifier0072T
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerNC BCBSNC PRIVATE DUTY

VIII. Authorized Official

Name: TERRI PILKINGTON
Title or Position: CFO
Credential:
Phone: 252-243-7808