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General NPI Number Information
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NPI Number | 1710214424
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Entity Type | Organization
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Legal Business Name | GIBSON CARE CORPORATION
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 608 SIGNAL HILL DRIVE EXT
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City | STATESVILLE
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State | NC
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Zip | 28625-4353
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Country | US
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Telephone | 704-924-9909
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Fax | 704-924-9165
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Provider Business Mailing Address
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Address Line | 608 SIGNAL HILL DRIVE EXT
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City | STATESVILLE
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State | NC
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Zip | 28625-4353
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Country | US
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Telephone | 704-924-9909
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Fax | 704-924-9165
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Authorized Official
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Title or Position | VP
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Name | MRS. TRACEY A GIBSON
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Credential |
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Telephone | 704-924-9909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HC3016
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License Number State | NC
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