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General NPI Number Information
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NPI Number | 1376698035
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Entity Type | Organization
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Legal Business Name | SUR-REGIONAL HOME CARE AGENCY,INC.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 W MAIN ST TIME TOWERS SUITE A
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City | ABERDEEN
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State | NC
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Zip | 28315-2754
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Country | US
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Telephone | 910-944-0989
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Fax | 910-944-0988
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Provider Business Mailing Address
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Address Line | 106 WEST MAIN STREET TIME TOWERS SUITE A
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City | ABERDEEN
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State | NC
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Zip | 28315-0000
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Country | US
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Telephone | 910-944-0989
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Fax | 910-944-0988
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CASSANDRA MCGOUGAN
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Credential |
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Telephone | 910-944-0989
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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 |
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License Number State |
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