Provider Demographics
NPI:1124216189
Name:INTERIM HEALTHCARE OF THE EASTERN CAROLINAS, INC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF THE EASTERN CAROLINAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-642-2106
Mailing Address - Street 1:PO BOX 2249
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-7249
Mailing Address - Country:US
Mailing Address - Phone:910-642-2106
Mailing Address - Fax:910-642-6580
Practice Address - Street 1:2413 ROBESON ST STE 7
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5500
Practice Address - Country:US
Practice Address - Phone:910-483-6144
Practice Address - Fax:910-483-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3459251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6800491Medicaid