Provider Demographics
NPI:1033443015
Name:PARKER CAP SERVICES
Entity Type:Organization
Organization Name:PARKER CAP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT AGENCY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-984-4988
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28002-0096
Mailing Address - Country:US
Mailing Address - Phone:704-984-4988
Mailing Address - Fax:704-984-4993
Practice Address - Street 1:302 N 1ST ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3905
Practice Address - Country:US
Practice Address - Phone:704-984-4988
Practice Address - Fax:704-984-4993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKER HOME CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418642Medicaid