MEDICARE: BLUE RAM 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1932055878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE RAM HOME CARE, LLC

Provider Business Mailing Address
First Line	:	10015 SMITH BASIN LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-9711
Country	:	US
Telephone Number	:	919-518-5549
Fax Number	:

Provider Business Practice Location Address
First Line	:	10015 SMITH BASIN LN
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-9711
Country	:	US
Telephone Number	:	919-518-5549
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW ADAM PARKER
Credential	:
Telephone Number	:	919-518-5549

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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