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 Field Definition 1
1 NPI 1275808651 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name EASTERN LIFE HOME HEALTH CARE.LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 140 CONCORD DR APT 8 The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name GREENVILLE The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name NC The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 278346495 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 2529452362 The telephone number associated with the location address of the provider being identified.
11 Provider Enumeration Date 3/19/2012 The date the provider was assigned a unique identifier (assigned an NPI).
12 Last Update Date 3/19/2012 The date that a record was last updated or changed.
13 Authorized Official Last Name BLOUNT The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
14 Authorized Official First Name EBONY The first name of the authorized official.
15 Authorized Official Middle Name NANTELLE The middle name of the authorized official.
16 Authorized Official Title or Position MANAGER The title or position of the authorized official.
17 Authorized Official Telephone Number 2529452362 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 251E00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 1248402 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 NC The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
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: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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