MEDICARE: AVID HEALTH AT HOME NORTH CAROLINA

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	385H00000X	Respite Care
2	251J00000X	Nursing Care Agency
3	251E00000X	Home Health Agency
4	253Z00000X	In Home Supportive Care Agency	HC1158	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	:	1942535760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVID HEALTH AT HOME NORTH CAROLINA

Provider Business Mailing Address
First Line	:	1508 MILITARY CUTOFF RD STE 304
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-5730
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	676 N SPENCE AVE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-4234
Country	:	US
Telephone Number	:	919-647-9303
Fax Number	:	910-521-8767

Authorized Official
Title or Position	:	CEO
Name	:	JENNIFER LENTZ
Credential	:
Telephone Number	:	910-728-4668

Provider Enumeration Date	:	10/13/2009
Last Update Date	:	05/29/2026

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