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NPI Code Detail

MEDICARE: JONJULIE HOME HEALTH SERVICES LLC

MEDICARE: JONJULIE HOME HEALTH SERVICES 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1962001669
Entity Type Code : Organization
Provider Name (Legal Business Name) : JONJULIE HOME HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 677 SHELLBARK DR
Second Line :
City : CONCORD
State : NC
Zip : 28025-9038
Country : US
Telephone Number : 704-507-9161
Fax Number :
Provider Business Practice Location Address
First Line : 9625 DAVID TAYLOR DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28262-2362
Country : US
Telephone Number : 704-507-9161
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : JONATHAN EJIM
Credential :
Telephone Number : 704-507-9161
Provider Enumeration Date : 10/22/2020
Last Update Date : 10/22/2020

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Directions to “JONJULIE HOME HEALTH SERVICES LLC ” Practice Location

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