MEDICARE: INTERIM HEALTHCARE OF THE EASTERN CAROLINAS, 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	HC3459	NC
2	251J00000X	Nursing Care Agency	HC3459	NC
3	253Z00000X	In Home Supportive Care Agency	HC3459	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871641506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF THE EASTERN CAROLINAS, INC

Provider Business Mailing Address
First Line	:	PO BOX 2249
Second Line	:
City	:	WHITEVILLE
State	:	NC
Zip	:	28472-7249
Country	:	US
Telephone Number	:	910-642-2106
Fax Number	:	910-642-6903

Provider Business Practice Location Address
First Line	:	2413-7 ROBESON STREET
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-5500
Country	:	US
Telephone Number	:	910-483-6144
Fax Number	:	910-483-6049

Authorized Official
Title or Position	:	PRESIDENT - OWNER
Name	:	MRS. DONNA L BYRD
Credential	:
Telephone Number	:	910-642-2106

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	01/09/2016

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