MEDICARE: TRIANGLE HOME HEALTH CARE, INC

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	HC1480	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710954078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIANGLE HOME HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	1413 BROAD ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-3534
Country	:	US
Telephone Number	:	919-286-0121
Fax Number	:	919-286-0076

Provider Business Practice Location Address
First Line	:	6810 BEACH DR SW STE F
Second Line	:
City	:	OCEAN ISLE BEACH
State	:	NC
Zip	:	28469-5440
Country	:	US
Telephone Number	:	910-575-4888
Fax Number	:	910-575-4888

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CONNIE TICE
Credential	:
Telephone Number	:	919-286-0121

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	03/31/2008

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