Provider Demographics
NPI:1124388350
Name:MYLES HOME HEALTH AGENCY II
Entity Type:Organization
Organization Name:MYLES HOME HEALTH AGENCY II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MYLES
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:919-282-6347
Mailing Address - Street 1:PO BOX 4696
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-0696
Mailing Address - Country:US
Mailing Address - Phone:919-282-6347
Mailing Address - Fax:252-206-1112
Practice Address - Street 1:4355 US HIGHWAY 264 ALT E
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-7616
Practice Address - Country:US
Practice Address - Phone:919-282-6347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3189251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health