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General NPI Number Information
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NPI Number | 1568656510
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Entity Type | Organization
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Legal Business Name | MERIDIAN HEALTHCARE OF NC, LLC
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 5300 ATLANTIC AVE SUITE 106-O
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City | RALEIGH
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State | NC
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Zip | 27609-1122
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Country | US
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Telephone | 919-878-9997
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Fax | 919-878-9901
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Provider Business Mailing Address
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Address Line | 5300 ATLANTIC AVE SUITE 106-O
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City | RALEIGH
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State | NC
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Zip | 27609-1122
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Country | US
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Telephone | 919-878-9997
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Fax | 919-878-9901
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ELIZA HAWKINS
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Credential | LPN
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Telephone | 919-878-9997
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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 | HC2987
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License Number State | NC
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