MEDICARE: UCHENNA JUNIOR RICHARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	251E00000X	Home Health Agency	NC
2	372600000X	Adult Companion	NC
3	374U00000X	Home Health Aide	NC
4	376K00000X	Nurse's Aide	NC
5	251J00000X	Nursing Care Agency	NC

General Provider Information

NPI Number	:	1982134607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UCHENNA JUNIOR RICHARDS

Provider Business Mailing Address
First Line	:	611 SUMMIT AVE STE 6
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27405-7746
Country	:	US
Telephone Number	:	336-491-8231
Fax Number	:	877-895-1090

Provider Business Practice Location Address
First Line	:	311 COLLEGE RD UNIT C
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5159
Country	:	US
Telephone Number	:	919-408-1642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	07/21/2022

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