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General NPI Number Information
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NPI Number | 1760931752
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Entity Type | Organization
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Legal Business Name | GERIDOCHOMECARE LLC
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Dates
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Enumeration Date | 10/01/2016
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Last Update Date | 10/01/2016
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Provider Practice Location Address
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Address Line | 28 SCHENCK PKWY STE 200
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City | ASHEVILLE
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State | NC
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Zip | 28803-5088
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Country | US
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Telephone | 828-424-8163
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Fax |
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Provider Business Mailing Address
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Address Line | 4431 MONTIBELLO DR
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City | CHARLOTTE
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State | NC
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Zip | 28226-7420
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALBERT SHEDERICK FORD JR.
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Credential | M.D.
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Telephone | 828-424-8163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HC4843
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License Number State | NC
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