=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407368715
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHIRP HOLDINGS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2017
-----------------------------------------------------
Last Update Date | 10/26/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 233 N SPRING ST
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27401-2231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-617-6001
-----------------------------------------------------
Fax | 336-617-8224
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 233 N SPRING ST
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27401-2231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-617-6001
-----------------------------------------------------
Fax | 336-617-8224
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HOWARD THOMAS DRIGGERS JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 336-617-6001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | HC3935
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------