Provider Demographics
NPI:1174662753
Name:MISS DAISY'S HEALTH CARE,INC.
Entity Type:Organization
Organization Name:MISS DAISY'S HEALTH CARE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MINCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-291-4915
Mailing Address - Street 1:PO BOX 1991
Mailing Address - Street 2:4000J WARD BLVD
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27894-1991
Mailing Address - Country:US
Mailing Address - Phone:252-529-1869
Mailing Address - Fax:252-291-8648
Practice Address - Street 1:4000 WARD BLVD STE J
Practice Address - Street 2:4000 J. WARD BLVD.
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3279
Practice Address - Country:US
Practice Address - Phone:252-291-8695
Practice Address - Fax:252-291-8648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC040476251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601085Medicaid
NC3409699Medicaid