Provider Demographics
NPI:1407856248
Name:UNIFIED HOME CARE, LLC
Entity Type:Organization
Organization Name:UNIFIED HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TABOR
Authorized Official - Last Name:HAIGLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-616-1955
Mailing Address - Street 1:8380 NC 87
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-8898
Mailing Address - Country:US
Mailing Address - Phone:336-616-1955
Mailing Address - Fax:336-616-1149
Practice Address - Street 1:8380 NC 87
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-8898
Practice Address - Country:US
Practice Address - Phone:336-616-1955
Practice Address - Fax:336-616-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0217251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3417121Medicaid
NC347121Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER