Healthcare Provider Details

I. General information

NPI: 1578502555
Provider Name (Legal Business Name): TEAMCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 LINN STATION RD
WINSTON SALEM NC
27106-3423
US

IV. Provider business mailing address

3990 LINN STATION RD
WINSTON SALEM NC
27106-3423
US

V. Phone/Fax

Practice location:
  • Phone: 336-777-0920
  • Fax: 336-777-0433
Mailing address:
  • Phone: 336-777-0920
  • Fax: 336-777-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberHC1576
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1576
License Number StateNC

VIII. Authorized Official

Name: MR. RICKEY ALLEN HOSKINS
Title or Position: RN/OWNER
Credential: RN
Phone: 336-777-0920