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General NPI Number Information
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NPI Number | 1336307263
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Entity Type | Organization
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Legal Business Name | HODGE CARE, INC.
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 3410 HEALY DR SUITE 200
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1403
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Country | US
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Telephone | 336-760-8001
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 HEALY DR
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1403
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHANNON HODGE
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Credential |
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Telephone | 336-760-8001
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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 | HC3350
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License Number State | NC
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