Provider Demographics
NPI:1417268665
Name:DAISY AND EDWARD HOME CARE AGENCY
Entity Type:Organization
Organization Name:DAISY AND EDWARD HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:EDWINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-439-4285
Mailing Address - Street 1:118 SOUTH MAIN STREET
Mailing Address - Street 2:P O BOX 1432
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27306
Mailing Address - Country:US
Mailing Address - Phone:910-439-4285
Mailing Address - Fax:
Practice Address - Street 1:118 SOUTH MAIN STREET
Practice Address - Street 2:118 SOUTH MAIN STREET
Practice Address - City:MOUNT GILEAD
Practice Address - State:NC
Practice Address - Zip Code:27306
Practice Address - Country:US
Practice Address - Phone:910-439-4285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health