MEDICARE: LRW HOME 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	251E00000X	Home Health Agency	HC1427	NC

General Provider Information

NPI Number	:	1689714503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LRW HOME CARE

Provider Business Mailing Address
First Line	:	2029 CEDAR POST CT
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-7362
Country	:	US
Telephone Number	:	336-784-4470
Fax Number	:

Provider Business Practice Location Address
First Line	:	2029 CEDAR POST CT
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-7362
Country	:	US
Telephone Number	:	336-784-4470
Fax Number	:	336-720-9350

Authorized Official
Title or Position	:	ASS'T ADMINISTRATOR
Name	:	MRS. DELPHENIA L WASHINGTON
Credential	:
Telephone Number	:	336-784-4470

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	08/22/2020

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