EASTERN LIFE HOME HEALTH CARE.LLC - NPI NUMBER 1275808651

Summary

Provider Name: EASTERN LIFE HOME HEALTH CARE.LLC

NPI Number: 1275808651

Clasification: Home Health (251E00000X)

Address:
140 CONCORD DR APT 8
GREENVILLE, NC
ZIP 27834

Phone Number: (252) 945-2362



Detailed Information

EASTERN LIFE HOME HEALTH CARE.LLC is a home health in Greenville, NC. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. The assigned NPI number for this provider is 1275808651 and is registered as an organization entity type.

The provider's business address is:

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

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251E00000X Home Health 1248402 NC Yes

NPI Record

No. Field Name Field Value
1 NPI 1275808651
2 Entity Type Code 2
3 Employer Identification Number EIN
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
25 Authorized Official Name Prefix Text MRS.
26 Authorized Official Credential Text CNA

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This page was last updated on: 11/14/2014
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.