Provider Demographics
NPI:1407124613
Name:SUNRISE HOME CARE INC
Entity Type:Organization
Organization Name:SUNRISE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:LENORA
Authorized Official - Last Name:MCSWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-663-0925
Mailing Address - Street 1:1754 E 11TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-2812
Mailing Address - Country:US
Mailing Address - Phone:919-663-0925
Mailing Address - Fax:919-663-0926
Practice Address - Street 1:1754 E 11TH ST STE D
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-2812
Practice Address - Country:US
Practice Address - Phone:919-663-0925
Practice Address - Fax:919-663-0926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNRISE HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-02
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3930251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418801Medicaid