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General NPI Number Information
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NPI Number | 1760792568
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Entity Type | Organization
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Legal Business Name | EXCEL HOME HEALTHCARE AGENCY & DME
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 1100 LOGGER CT STE D100
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City | RALEIGH
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State | NC
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Zip | 27609
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Country | US
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Telephone | 919-800-0221
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Fax | 919-800-0221
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Provider Business Mailing Address
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Address Line | 1100 LOGGER CT STE D100
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City | RALEIGH
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State | NC
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Zip | 27609-8509
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Country | US
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Telephone | 919-800-0221
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Fax | 919-800-0221
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Authorized Official
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Title or Position | OWNER
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Name | MR. MOMODOU JAITEH
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Credential |
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Telephone | 919-601-6723
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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 | HC4250
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 136624
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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