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General NPI Number Information
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NPI Number | 1669094413
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Entity Type | Organization
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Legal Business Name | STALWART HOME HEALTH LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 814 ROCK QUARRY RD
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City | RALEIGH
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State | NC
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Zip | 27610-5000
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Country | US
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Telephone | 919-400-0592
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Fax |
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Provider Business Mailing Address
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Address Line | 6032 WATSONIA DR
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City | ZEBULON
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State | NC
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Zip | 27597-8943
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Country | US
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Telephone | 919-400-0592
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | FRANCIS EGBOM
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Credential |
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Telephone | 919-670-9006
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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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