Provider Demographics
NPI:1578502555
Name:TEAMCARE INC.
Entity Type:Organization
Organization Name:TEAMCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKEY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:336-777-0920
Mailing Address - Street 1:3990 LINN STATION RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3423
Mailing Address - Country:US
Mailing Address - Phone:336-777-0920
Mailing Address - Fax:336-777-0433
Practice Address - Street 1:3990 LINN STATION RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3423
Practice Address - Country:US
Practice Address - Phone:336-777-0920
Practice Address - Fax:336-777-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1576251C00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600557Medicaid