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	HC4648	NC
2	251F00000X	Home Infusion Agency	HC4648	NC
3	251J00000X	Nursing Care Agency	HC4648	NC

General Provider Information

NPI Number	:	1871912691
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	:	1904 GUM BRANCH RD
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28540-4532
Country	:	US
Telephone Number	:	910-347-5100
Fax Number	:	910-939-5170

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DONNA LOU BYRD
Credential	:
Telephone Number	:	910-642-2106

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	07/04/2019

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