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General NPI Number Information
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NPI Number | 1538042510
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Entity Type | Organization
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Legal Business Name | INTERCARE
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 2880 NORTHCROSS DR
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City | HEBRON
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State | KY
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Zip | 41048-6710
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Country | US
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Telephone | 919-724-9141
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Fax |
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Provider Business Mailing Address
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Address Line | 2880 NORTHCROSS DR
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City | HEBRON
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State | KY
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Zip | 41048-6710
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Country | US
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Telephone | 919-724-9141
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JAY J MAKONYONGA
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Credential |
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Telephone | 919-724-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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