Provider Demographics
NPI:1003027467
Name:FIRST PATH HOME CARE SERVICES
Entity Type:Organization
Organization Name:FIRST PATH HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:910-291-0240
Mailing Address - Street 1:1687 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5429
Mailing Address - Country:US
Mailing Address - Phone:910-291-0240
Mailing Address - Fax:910-291-0243
Practice Address - Street 1:1687 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5429
Practice Address - Country:US
Practice Address - Phone:910-291-0240
Practice Address - Fax:910-291-0243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3415251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418200Medicaid