Provider Demographics
NPI:1225260938
Name:AHC CAP SERVICES
Entity Type:Organization
Organization Name:AHC CAP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-334-3514
Mailing Address - Street 1:1319 BEATTIES FORD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-5037
Mailing Address - Country:US
Mailing Address - Phone:704-334-3514
Mailing Address - Fax:704-333-7249
Practice Address - Street 1:1319 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-5037
Practice Address - Country:US
Practice Address - Phone:704-334-3514
Practice Address - Fax:704-333-7249
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGIANCE HOME CARE OF THE CAROLINAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3137251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418067Medicaid