Provider Demographics
NPI:1497871339
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:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-420-0336
Mailing Address - Street 1:3710 UNIVERSITY DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6203
Mailing Address - Country:US
Mailing Address - Phone:919-420-0336
Mailing Address - Fax:919-420-0172
Practice Address - Street 1:4325 LAKE BOONE TRL
Practice Address - Street 2:SUITE 102
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7509
Practice Address - Country:US
Practice Address - Phone:919-420-0336
Practice Address - Fax:919-420-0172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2075163W00000X, 164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Not Answered164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7100424Medicaid