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General NPI Number Information
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NPI Number | 1801057336
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Entity Type | Organization
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Legal Business Name | ST LUKE HOME CARE SERVICES
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 101 NEVILLE ST
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City | PRINCEVILLE
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State | NC
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Zip | 27886-5327
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Country | US
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Telephone | 252-823-7175
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Fax | 252-823-6244
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Provider Business Mailing Address
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Address Line | PO BOX 13
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City | TARBORO
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State | NC
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Zip | 27886-0013
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Country | US
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Telephone | 252-823-7175
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Fax | 252-823-6244
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | VERA DAVIS
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Credential |
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Telephone | 252-823-7175
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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 | HC3500
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License Number State | NC
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