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General NPI Number Information
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NPI Number | 1265754204
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Entity Type | Organization
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Legal Business Name | MURRAY FORK HOME 3 INC.
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 1555 CAIN RD STE 201
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-3076
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Country | US
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Telephone | 910-480-4181
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Fax | 910-480-4182
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Provider Business Mailing Address
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Address Line | PO BOX 35674
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-0674
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Country | US
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Telephone | 910-480-4181
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Fax | 910-480-4182
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DEBRA BIDDLE
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Credential |
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Telephone | 910-480-4181
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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 | HC3943
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License Number State | NC
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