Healthcare Provider Details

I. General information

NPI: 1922206770
Provider Name (Legal Business Name): CAROLINA STAFFING & HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 TARBORO ST W SUITE C
WILSON NC
27893-4771
US

IV. Provider business mailing address

806 TARBORO ST W SUITE C
WILSON NC
27893-4771
US

V. Phone/Fax

Practice location:
  • Phone: 252-237-7898
  • Fax: 252-237-3315
Mailing address:
  • Phone: 252-237-7898
  • Fax: 252-237-3315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC3379
License Number StateNC

VII. Legacy identifiers

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

# 1
IdentifierHC3379
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerNC LICENSE NUMBER

VIII. Authorized Official

Name: MR. ISRAEL UDOCHUKWU OJIMADU
Title or Position: OWNER
Credential: ADMINISTRATOR
Phone: 252-237-7898