Provider Demographics
NPI:1275161580
Name:LONDYN HOMECARE AGENCY L.L.C
Entity Type:Organization
Organization Name:LONDYN HOMECARE AGENCY L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEBOROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-449-7995
Mailing Address - Street 1:2322 BRENLY CT.
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE, N.C
Mailing Address - State:NC
Mailing Address - Zip Code:28269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1914J.N. PLACE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:980-859-2572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health