=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376104877
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAY SEVEN HOME HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2019
-----------------------------------------------------
Last Update Date | 06/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5401 MALLARD DR S
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28227-3110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-449-5420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5401 MALLARD DR S
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28227-3110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-449-5420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TIARA SADE 294864023
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 704-449-5420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------