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General NPI Number Information
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NPI Number | 1861490161
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Entity Type | Organization
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Legal Business Name | GASTON MEMORIAL HOME HEALTH CARE/MED.INC.
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 200 E 2ND AVE
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City | GASTONIA
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State | NC
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Zip | 28052-4358
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Country | US
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Telephone | 704-834-2025
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Fax | 704-834-2038
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Provider Business Mailing Address
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Address Line | PO BOX 2568
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City | GASTONIA
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State | NC
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Zip | 28053-2568
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Country | US
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Telephone | 704-834-2025
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Fax | 704-834-2038
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KIMBER Z WALTERS
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Credential |
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Telephone | 704-834-2025
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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 | HC0906
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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 |
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License Number State |
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