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General NPI Number Information
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NPI Number | 1619655131
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Entity Type | Organization
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Legal Business Name | MEDLINK HOMECARE LLC
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 2307 W CONE BLVD STE 110A
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City | GREENSBORO
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State | NC
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Zip | 27408-4063
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Country | US
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Telephone | 276-444-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 2307 W CONE BLVD STE 110A
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City | GREENSBORO
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State | NC
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Zip | 27408-4063
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Country | US
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Telephone | 276-444-1814
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMIE TRENELL HICKMAN II
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Credential |
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Telephone | 980-263-8436
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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 |
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License Number State |
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