1275808651 NPI NUMBER - EASTERN LIFE HOME HEALTH CARE.LLC
Summary
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NPI Number |
1275808651 |
| Entity Type Code |
Organization |
| Provider Legal Name |
EASTERN LIFE HOME HEALTH CARE.LLC |
| Provider Business Practice Location Address |
140 CONCORD DR APT 8
GREENVILLE, NC
ZIP 27834
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| Practice Location Phone Number |
(252) 945-2362 |
| Provider Taxonomy Code |
251E00000X - Home Health |
| Specialization |
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| Provider Enumeration Date |
3/19/2012 |
| Last Update Date |
3/19/2012 |
NPI Number 1275808651 is assigned to an organization registered under the healthcare provider name EASTERN LIFE HOME HEALTH CARE.LLC .
The provider is physically located at:
140 CONCORD DR APT 8
GREENVILLE, NC
ZIP 27834-495
Phone: (252) 945-2362
The provider's authorized official is EBONY NANTELLE BLOUNT .
The authorized official title is MANAGER and has the following contact phone number (252) 945-2362 .
The enumeration date for this NPI number is 3/19/2012 and was last updated on 3/19/2012 .
Map - Location of Practice
Taxonomy Codes
The following information regarding the scope of practice of this provider is available:
| 1 |
251E00000X |
Home Health |
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1248402 |
NC |
View Code |
Other (Legacy) Identifiers
The following legacy identifiers for this provider are available:
NPI Record
| 1 |
NPI |
1275808651 |
| 2 |
Entity Type Code |
2 |
| 3 |
Employer Identification Number EIN |
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| 4 |
Provider Organization Name Legal Business Name |
EASTERN LIFE HOME HEALTH CARE.LLC |
| 5 |
Provider First Line Business Practice Location Address |
140 CONCORD DR APT 8 |
| 6 |
Provider Business Practice Location Address City Name |
GREENVILLE |
| 7 |
Provider Business Practice Location Address State Name |
NC |
| 8 |
Provider Business Practice Location Address Postal Code |
278346495 |
| 9 |
Provider Business Practice Location Address Country Code If outside U S |
US |
| 10 |
Provider Business Practice Location Address Telephone Number |
2529452362 |
| 11 |
Provider Enumeration Date |
3/19/2012 |
| 12 |
Last Update Date |
3/19/2012 |
| 13 |
Authorized Official Last Name |
BLOUNT |
| 14 |
Authorized Official First Name |
EBONY |
| 15 |
Authorized Official Middle Name |
NANTELLE |
| 16 |
Authorized Official Title or Position |
MANAGER |
| 17 |
Authorized Official Telephone Number |
2529452362 |
| 18 |
Healthcare Provider Taxonomy Code 1 |
251E00000X |
| 19 |
Provider License Number 1 |
1248402 |
| 20 |
Provider License Number State Code 1 |
NC |
| 21 |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
| 22 |
Is Organization Subpart |
Y |
| 23 |
Parent Organization LBN |
EASTERN LIFE HOME HEALTH CARE.LLC |
| 24 |
Parent Organization TIN |
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| 25 |
Authorized Official Name Prefix Text |
MRS. |
| 26 |
Authorized Official Credential Text |
CNA |
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This page was last updated on: 5/14/2013
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.