=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891846093
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACCOUNTABLE HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2007
-----------------------------------------------------
Last Update Date | 07/16/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 COMMERCE ST STE A
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27858-5030
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-355-7559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1332
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27835-1332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-355-7559
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. GLORIA JEAN WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-355-7559
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HC3279
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------