Provider Demographics
NPI:1497809172
Name:GERICARE & HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:GERICARE & HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MERVYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-688-8000
Mailing Address - Street 1:505 S DUKE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3199
Mailing Address - Country:US
Mailing Address - Phone:919-688-8000
Mailing Address - Fax:919-688-8004
Practice Address - Street 1:505 S DUKE ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3199
Practice Address - Country:US
Practice Address - Phone:919-688-8000
Practice Address - Fax:919-688-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0518251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600245Medicaid
NC6800228Medicaid
NC7100113Medicaid
NC3408462Medicaid