Provider Demographics
NPI:1033441944
Name:CARE ONE HOME CARE SPECIALISTS
Entity Type:Organization
Organization Name:CARE ONE HOME CARE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:HOOPER
Authorized Official - Last Name:SHORE
Authorized Official - Suffix:
Authorized Official - Credentials:CNA 1
Authorized Official - Phone:336-293-4499
Mailing Address - Street 1:163 STRATFORD CT STE 265
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1834
Mailing Address - Country:US
Mailing Address - Phone:336-293-4499
Mailing Address - Fax:336-764-8948
Practice Address - Street 1:163 STRATFORD CT STE 265
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1834
Practice Address - Country:US
Practice Address - Phone:336-293-4499
Practice Address - Fax:336-764-8948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4003253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care