Provider Demographics
NPI:1114561800
Name:WAR MEMORIAL HOME HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:WAR MEMORIAL HOME HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:ELROY
Authorized Official - Last Name:TANKARD
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:919-908-1357
Mailing Address - Street 1:6409 FAYETTEVILLE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6297
Mailing Address - Country:US
Mailing Address - Phone:919-908-1357
Mailing Address - Fax:919-869-2785
Practice Address - Street 1:12336 TETONS CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8903
Practice Address - Country:US
Practice Address - Phone:919-908-1357
Practice Address - Fax:919-869-2785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251E00000XAgenciesHome Health