Provider Demographics
NPI:1043507197
Name:ONE CARE NC INC
Entity Type:Organization
Organization Name:ONE CARE NC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MATUTU
Authorized Official - Middle Name:
Authorized Official - Last Name:NYABANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-506-9577
Mailing Address - Street 1:10418 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ARCHDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27263-3281
Mailing Address - Country:US
Mailing Address - Phone:336-803-4001
Mailing Address - Fax:
Practice Address - Street 1:10418 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ARCHDALE
Practice Address - State:NC
Practice Address - Zip Code:27263-3281
Practice Address - Country:US
Practice Address - Phone:336-803-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care