Provider Demographics
NPI:1457485963
Name:INTERIM HEALTHCARE OF THE TRIANGLE, LLC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF THE TRIANGLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:BRYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-493-7575
Mailing Address - Street 1:3710 UNIVERSITY DR STE 135
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6259
Mailing Address - Country:US
Mailing Address - Phone:919-493-7575
Mailing Address - Fax:191-949-3045
Practice Address - Street 1:3710 UNIVERSITY DR
Practice Address - Street 2:SUITE 130
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6203
Practice Address - Country:US
Practice Address - Phone:919-493-7575
Practice Address - Fax:191-949-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2075163W00000X, 3747P1801X, 374U00000X, 376K00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600784Medicaid