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General NPI Number Information
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NPI Number | 1558403915
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Entity Type | Organization
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Legal Business Name | LANDRUM, INC.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 542 WILLIAMSON RD SUITE 5
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City | MOORESVILLE
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State | NC
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Zip | 28117-8193
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Country | US
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Telephone | 704-663-1065
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Fax | 704-660-1851
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Provider Business Mailing Address
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Address Line | 542 WILLIAMSON RD SUITE 5
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City | MOORESVILLE
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State | NC
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Zip | 28117-8193
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Country | US
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Telephone | 704-663-1065
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Fax | 704-660-1851
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. TRACY RAY LANDRUM
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Credential |
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Telephone | 704-663-1065
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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 | HC3210
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License Number State | NC
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