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General NPI Number Information
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NPI Number | 1154451078
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Entity Type | Organization
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Legal Business Name | MARY B HOME CARE
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 1107 N FAIRVIEW RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27801-6291
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Country | US
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Telephone | 252-972-4080
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Fax | 252-972-3380
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | ROCKY MOUNT
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State | NC
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Zip | 27802-0909
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Country | US
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Telephone | 252-972-4080
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Fax | 252-972-3380
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Authorized Official
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Title or Position | CEO
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Name | MR. KELVIN BARNHILL
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Credential |
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Telephone | 252-972-4080
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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 | HC2820
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License Number State | NC
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