Provider Demographics
NPI:1346883410
Name:SAFETYMEDS HOME HEALTH INC
Entity Type:Organization
Organization Name:SAFETYMEDS HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ARCHIBONG
Authorized Official - Last Name:JACK
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:919-633-9397
Mailing Address - Street 1:5540 CENTERVIEW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3386
Mailing Address - Country:US
Mailing Address - Phone:919-637-2303
Mailing Address - Fax:
Practice Address - Street 1:5540 CENTERVIEW DR STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3386
Practice Address - Country:US
Practice Address - Phone:919-637-2303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAFETYMEDS HOME HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333300000XSuppliersEmergency Response System CompaniesGroup - Single Specialty
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, ChildGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1903724OtherSECRETARY OF STATES