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General NPI Number Information
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NPI Number | 1134454341
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Entity Type | Organization
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Legal Business Name | SCOTT CARE SERVOCE
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 1618 HERALDRY LN
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City | GREENSBORO
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State | NC
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Zip | 27455-9202
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Country | US
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Telephone | 336-540-1390
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Fax | 336-540-1390
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Provider Business Mailing Address
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Address Line | 1618 HERALDRY LN
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City | GREENSBORO
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State | NC
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Zip | 27455-9202
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Country | US
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Telephone | 336-540-1390
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Fax | 336-540-1390
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY JEANNETTE SCOTT
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Credential |
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Telephone | 336-540-1390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 219767
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License Number State | NC
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