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General NPI Number Information
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NPI Number | 1902948631
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PROVIDERS HOME CARE
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 700 PROGRESS PL # B
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City | LAURINBURG
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State | NC
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Zip | 28352-5545
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Country | US
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Telephone | 910-276-3350
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Fax | 910-276-4450
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Provider Business Mailing Address
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Address Line | 700 PROGRESS PL # B
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City | LAURINBURG
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State | NC
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Zip | 28352-5545
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Country | US
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Telephone | 910-276-3350
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Fax | 910-276-4450
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. PAUL G BROOKS
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Credential |
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Telephone | 910-276-3350
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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 | HC1320
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License Number State | NC
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