Provider Demographics
NPI:1144559980
Name:HEWITT HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:HEWITT HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-375-7410
Mailing Address - Street 1:3908 LLOYDS CT
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9772
Mailing Address - Country:US
Mailing Address - Phone:336-375-7410
Mailing Address - Fax:
Practice Address - Street 1:1105 E WENDOVER AVE
Practice Address - Street 2:SUITE E
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6774
Practice Address - Country:US
Practice Address - Phone:336-375-7410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty