Provider Demographics
NPI:1346395019
Name:W&B HEALTH CARE
Entity Type:Organization
Organization Name:W&B HEALTH CARE
Other - Org Name:RENNERT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-843-1997
Mailing Address - Street 1:130 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:RED SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28377
Mailing Address - Country:US
Mailing Address - Phone:910-843-2710
Mailing Address - Fax:910-843-2171
Practice Address - Street 1:130 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RED SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28377-1512
Practice Address - Country:US
Practice Address - Phone:910-843-2710
Practice Address - Fax:910-843-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7803941Medicaid
NC3409215Medicaid
NC6601200Medicaid
NC8300702BMedicaid
NC8300702Medicaid