MEDICARE: UNIQUELY ME HOME CARE LLC

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

General Provider Information

NPI Number	:	1811587991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIQUELY ME HOME CARE LLC

Provider Business Mailing Address
First Line	:	2409 CHARLES BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5925
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 CHARLES BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5925
Country	:	US
Telephone Number	:	252-217-3053
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MR. JAMES JONES
Credential	:
Telephone Number	:	252-217-3053

Provider Enumeration Date	:	01/21/2021
Last Update Date	:	01/21/2021

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