Provider Demographics
NPI:1427210806
Name:HEALTHCORE RESOURCE INC
Entity Type:Organization
Organization Name:HEALTHCORE RESOURCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:WAMBUI
Authorized Official - Last Name:NYAMBURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-872-1178
Mailing Address - Street 1:3209 GUESS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2692
Mailing Address - Country:US
Mailing Address - Phone:919-872-1178
Mailing Address - Fax:919-872-1170
Practice Address - Street 1:3209 GUESS RD STE 101
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2692
Practice Address - Country:US
Practice Address - Phone:919-872-1178
Practice Address - Fax:919-872-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409613Medicaid