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General NPI Number Information
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NPI Number | 1528860210
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Entity Type | Organization
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Legal Business Name | CAROLINA HOMEHEALTH AGENCY LLC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 1983 FAIRFOREST DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-2612
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Country | US
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Telephone | 910-541-5188
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Fax |
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Provider Business Mailing Address
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Address Line | 1983 FAIRFOREST DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-2612
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Country | US
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Telephone | 910-541-5188
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. THEOPHILUS IMBUFE
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Credential | DHA,MBA
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Telephone | 910-733-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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