MEDICARE: THE EAST FAMILY CARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	FCL-079-002	NC

General Provider Information

NPI Number	:	1558585257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE EAST FAMILY CARE

Provider Business Mailing Address
First Line	:	843 WORSHAM MILL RD
Second Line	:	PO BOX 178
City	:	RUFFIN
State	:	NC
Zip	:	27326
Country	:	US
Telephone Number	:	336-939-7678
Fax Number	:	336-939-9444

Provider Business Practice Location Address
First Line	:	843 WORSHAM MILL RD
Second Line	:
City	:	RUFFIN
State	:	NC
Zip	:	27326
Country	:	US
Telephone Number	:	336-939-7678
Fax Number	:	336-939-9444

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MERNELLA MAI SHEFFIELD
Credential	:
Telephone Number	:	336-939-7678

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	10/10/2012

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Directions to “THE EAST FAMILY CARE ” Practice Location

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