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General NPI Number Information
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NPI Number | 1386882728
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Entity Type | Organization
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Legal Business Name | J&J HOME CARE AGENCY
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 111 LAMON ST SUITE 216
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-4901
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Country | US
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Telephone | 910-874-5523
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Fax | 910-263-8719
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Provider Business Mailing Address
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Address Line | PO BOX 3163
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City | FAYETTEVILLE
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State | NC
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Zip | 28302-3163
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Country | US
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Telephone | 910-874-5523
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Fax | 910-822-9702
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Authorized Official
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Title or Position | OWNET
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Name | MRS. TERESA M MARIBLE
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Credential |
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Telephone | 910-874-5523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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