MEDICARE: CAREBRIDGE HOMECARE AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	253Z00000X	In Home Supportive Care Agency
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1013605476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREBRIDGE HOMECARE AGENCY

Provider Business Mailing Address
First Line	:	2505 FAIRVIEW ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-4919
Country	:	US
Telephone Number	:	336-907-3030
Fax Number	:	336-676-4045

Provider Business Practice Location Address
First Line	:	2505 FAIRVIEW ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-4919
Country	:	US
Telephone Number	:	336-907-3030
Fax Number	:	336-676-4045

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TYISIHA HENRY
Credential	:
Telephone Number	:	336-405-4946

Provider Enumeration Date	:	04/25/2023
Last Update Date	:	04/25/2023

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Directions to “CAREBRIDGE HOMECARE AGENCY ” Practice Location

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