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General NPI Number Information
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NPI Number | 1346473832
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Entity Type | Organization
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Legal Business Name | VILLAGE HOME CARE AND PERSONNEL POOL
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 1945 FORDHAM DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3650
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Country | US
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Telephone | 910-483-2263
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Fax | 910-483-5668
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Provider Business Mailing Address
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Address Line | 1945 FORDHAM DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3650
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Country | US
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Telephone | 910-483-2263
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Fax | 910-483-5668
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Authorized Official
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Title or Position | OWNER
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Name | DR. FRANKLIN CLARK III
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Credential | MD
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Telephone | 910-483-2263
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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 | HC3876
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License Number State | NC
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