Provider Demographics
NPI:1265682892
Name:MURRAY FORK HOME CARE
Entity Type:Organization
Organization Name:MURRAY FORK HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-480-4181
Mailing Address - Street 1:PO BOX 35674
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-0674
Mailing Address - Country:US
Mailing Address - Phone:910-480-4181
Mailing Address - Fax:910-480-4182
Practice Address - Street 1:1555 CAIN RD STE 201
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-3076
Practice Address - Country:US
Practice Address - Phone:910-480-4181
Practice Address - Fax:910-480-4182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006479Medicaid