Provider Demographics
NPI:1073668232
Name:PERSONAL HOMECARE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:PERSONAL HOMECARE SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE SUPERVISOR OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-580-9045
Mailing Address - Street 1:PO BOX 11270
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27532-1270
Mailing Address - Country:US
Mailing Address - Phone:919-580-9045
Mailing Address - Fax:919-580-9044
Practice Address - Street 1:1708 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2272
Practice Address - Country:US
Practice Address - Phone:919-580-9045
Practice Address - Fax:919-580-9044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC28473747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS5125Medicaid