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General NPI Number Information
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NPI Number | 1154903623
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HOME CARE LLC
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Dates
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Enumeration Date | 04/24/2021
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Last Update Date | 01/06/2023
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Provider Practice Location Address
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Address Line | 301 S GREENE ST STE 8F
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City | GREENSBORO
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State | NC
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Zip | 27401-2660
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Country | US
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Telephone | 910-920-7726
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Fax |
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Provider Business Mailing Address
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Address Line | 2216 W MEADOWVIEW RD STE 114
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City | GREENSBORO
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State | NC
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Zip | 27407-3401
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Country | US
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Telephone | 336-541-8046
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TOIQUINA MCKOY
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Credential | CMA,CNA
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Telephone | 336-541-8046
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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 |
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License Number State |
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