Provider Demographics
NPI:1568039170
Name:MEDIQUE HOMECARE STAFFING, INC.
Entity Type:Organization
Organization Name:MEDIQUE HOMECARE STAFFING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOVELYN
Authorized Official - Middle Name:CHIDIEBERE
Authorized Official - Last Name:CHIDEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-889-4890
Mailing Address - Street 1:5821 PARKCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8436
Mailing Address - Country:US
Mailing Address - Phone:919-889-4890
Mailing Address - Fax:
Practice Address - Street 1:2 CENTERVIEW DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3717
Practice Address - Country:US
Practice Address - Phone:919-889-4890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care