MEDICARE: TENDER LOVING CARE HOME HEALTH CARE

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	:	1952782013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER LOVING CARE HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	9635 SOUTHERN PINE BLVD
Second Line	:	SUITE # 136
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5540
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9635 SOUTHERN PINE BLVD
Second Line	:	SUITE # 136
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5540
Country	:	US
Telephone Number	:	704-578-8833
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. SHARON ANITA MCINNIS
Credential	:
Telephone Number	:	704-578-8833

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	11/09/2015

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