=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154121663
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMAZIN HOME HEALTH CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2025
-----------------------------------------------------
Last Update Date | 03/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1842 S MADISON ST
-----------------------------------------------------
City | WHITEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28472-4938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-840-2343
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 221 BUTLER RD
-----------------------------------------------------
City | CLARENDON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28432-9371
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-840-2343
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ORGANIZER
-----------------------------------------------------
Name | SHEILA CRIBB
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 910-840-2343
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------