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General NPI Number Information
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NPI Number | 1023209855
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Entity Type | Organization
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Legal Business Name | JABEZ HOME INFUSION COMPANY
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 10/27/2007
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Provider Practice Location Address
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Address Line | 2495 HEMBY LN SUITE B
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City | GREENVILLE
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State | NC
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Zip | 27834-3771
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Country | US
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Telephone | 252-758-9304
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Fax | 252-758-6904
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Provider Business Mailing Address
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Address Line | 2495 HEMBY LN SUITE B
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City | GREENVILLE
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State | NC
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Zip | 27834-3771
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Country | US
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Telephone | 252-758-9304
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Fax | 252-758-6904
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DEBRA PATTEN COWART
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Credential | CPHT
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Telephone | 252-758-9304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 08132
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 08132
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License Number State | NC
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