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General NPI Number Information
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NPI Number | 1114169398
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Entity Type | Organization
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Legal Business Name | ST. LUKE HOME CARE SERVICES
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 101 NEVILLE ST POB 13
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City | PRINCEVILLE
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State | NC
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Zip | 27886-5327
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Country | US
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Telephone | 252-823-7176
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Fax | 252-823-6244
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Provider Business Mailing Address
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Address Line | 101 NEVILLE ST POB 13
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City | PRINCEVILLE
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State | NC
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Zip | 27886-5327
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Country | US
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Telephone | 252-823-7176
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Fax | 252-823-6244
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MRS. VERA DAVIS
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Credential | RN
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Telephone | 252-823-7175
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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 | HC3500
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License Number State | NC
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