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General NPI Number Information
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NPI Number | 1053692806
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Entity Type | Organization
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Legal Business Name | ALLCARE HEALTH SOURCE L.L.C.
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 806 ARENDALE B
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City | ZEBULON
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State | NC
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Zip | 27597
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Country | US
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Telephone | 800-720-5685
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Fax | 877-497-3401
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Provider Business Mailing Address
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Address Line | 806 N HIGHWAY 96 SUITE B
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City | ZEBULON
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State | NC
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Zip | 27597
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Country | US
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Telephone | 800-720-5685
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Fax | 877-497-3401
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JAMES RICHARD GRIFFIN
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Credential | R.N.
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Telephone | 800-720-5685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 206694
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License Number State | NC
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