Healthcare Provider Details

I. General information

NPI: 1528545498
Provider Name (Legal Business Name): NORTH CAROLINA IN-HOME PARTNER-VIII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 TARBORO ST SW STE 304
WILSON NC
27893
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 252-237-4335
  • Fax: 252-293-8302
Mailing address:
  • Phone: 337-233-1307
  • Fax:

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: JOSHUA L PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307