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General NPI Number Information
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NPI Number | 1275617284
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Entity Type | Organization
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Legal Business Name | CARE SOUTH INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3016 TWINS PL
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City | BOONVILLE
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State | NC
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Zip | 27011-8961
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Country | US
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Telephone | 336-468-1710
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Fax | 336-468-8709
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Provider Business Mailing Address
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Address Line | 3016 TWINS PL
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City | BOONVILLE
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State | NC
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Zip | 27011-8961
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Country | US
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Telephone | 336-468-1710
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Fax | 336-468-8709
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Authorized Official
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Title or Position | OWNER DIRECTOR
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Name | MRS. DARA JESTER PURYEAR
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Credential | REGISTERED NURSE
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Telephone | 336-468-1710
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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 | HC2086
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License Number State | NC
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