Provider Demographics
NPI:1508298449
Name:BOB INMAN INCORPORATED
Entity Type:Organization
Organization Name:BOB INMAN INCORPORATED
Other - Org Name:INMAN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR, QP
Authorized Official - Prefix:
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BA, QP
Authorized Official - Phone:910-609-1800
Mailing Address - Street 1:PO BOX 35333
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-0333
Mailing Address - Country:US
Mailing Address - Phone:910-609-1800
Mailing Address - Fax:704-885-9974
Practice Address - Street 1:5111 SHADY LAWN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28348-3484
Practice Address - Country:US
Practice Address - Phone:910-609-1800
Practice Address - Fax:704-885-9974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408735Medicaid