Provider Demographics
NPI:1083735252
Name:MAJOR HOME CARE AGENCY
Entity Type:Organization
Organization Name:MAJOR HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-231-9166
Mailing Address - Street 1:PO BOX 663
Mailing Address - Street 2:529 NORTH SUNSET
Mailing Address - City:ATKINSON
Mailing Address - State:NC
Mailing Address - Zip Code:28421-9231
Mailing Address - Country:US
Mailing Address - Phone:910-283-9444
Mailing Address - Fax:910-283-9445
Practice Address - Street 1:106 WEST CHURCH STREET
Practice Address - Street 2:
Practice Address - City:ATKINSON
Practice Address - State:NC
Practice Address - Zip Code:28421-9231
Practice Address - Country:US
Practice Address - Phone:910-283-9444
Practice Address - Fax:910-283-9445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1837376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409193Medicaid
NC6600688Medicaid