EASTERN LIFE HOME HEALTH CARE.LLC - NPI NUMBER 1275808651
Provider Name: EASTERN LIFE HOME HEALTH CARE.LLC
NPI Number: 1275808651
Clasification: Home Health (251E00000X)
140 CONCORD DR APT 8
Phone Number: (252) 945-2362
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
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
The following information regarding the scope of practice of this provider is available:
||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.
||Entity Type Code
||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).
||Employer Identification Number EIN
||The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
||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.
||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.
||Provider Business Practice Location Address City Name
||The city name in the location address of the provider being identified.
||Provider Business Practice Location Address State Name
||The State code in the location of the provider
||Provider Business Practice Location Address Postal Code
||The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
||Provider Business Practice Location Address Country Code If outside U S
||The country code in the location address of the provider being identified.
||Provider Business Practice Location Address Telephone Number
||The telephone number associated with the location address of the provider being identified.
||Provider Enumeration Date
||The date the provider was assigned a unique identifier (assigned an NPI).
||Last Update Date
||The date that a record was last updated or changed.
||Authorized Official Last Name
||The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
||Authorized Official First Name
||The first name of the authorized official.
||Authorized Official Middle Name
||The middle name of the authorized official.
||Authorized Official Title or Position
||The title or position of the authorized official.
||Authorized Official Telephone Number
||The 10-position telephone number of the authorized official.
||Healthcare Provider Taxonomy Code 1
||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.
||Provider License Number 1
||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’’.
||Provider License Number State Code 1
||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.
||Healthcare Provider Primary Taxonomy Switch 1
||Is Organization Subpart
||Parent Organization LBN
||EASTERN LIFE HOME HEALTH CARE.LLC
||Parent Organization TIN
||Authorized Official Name Prefix Text
||Authorized Official Credential Text
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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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