Provider Demographics
NPI:1376698035
Name:SUR-REGIONAL HOME CARE AGENCY,INC.
Entity Type:Organization
Organization Name:SUR-REGIONAL HOME CARE AGENCY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGOUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-944-0989
Mailing Address - Street 1:106 WEST MAIN STREET
Mailing Address - Street 2:TIME TOWERS SUITE A
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-0000
Mailing Address - Country:US
Mailing Address - Phone:910-944-0989
Mailing Address - Fax:910-944-0988
Practice Address - Street 1:106 W MAIN ST
Practice Address - Street 2:TIME TOWERS SUITE A
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2754
Practice Address - Country:US
Practice Address - Phone:910-944-0989
Practice Address - Fax:910-944-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health