Provider Demographics
NPI:1255495156
Name:HOMECARE NURSING, INC.
Entity Type:Organization
Organization Name:HOMECARE NURSING, INC.
Other - Org Name:VANCE COUNTY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAKPUDA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-438-5309
Mailing Address - Street 1:943 W ANDREWS AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-2516
Mailing Address - Country:US
Mailing Address - Phone:252-438-5309
Mailing Address - Fax:
Practice Address - Street 1:943 W ANDREWS AVE
Practice Address - Street 2:SUITE G
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-2516
Practice Address - Country:US
Practice Address - Phone:252-438-5309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2288251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409503Medicaid
NC6600901Medicaid