Provider Demographics
NPI:1578612818
Name:INTERIM HEALTHCARE OF THE EASTERN CAROLINAS, INC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF THE EASTERN CAROLINAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-642-2106
Mailing Address - Street 1:PO BOX 2249
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-7249
Mailing Address - Country:US
Mailing Address - Phone:910-642-2106
Mailing Address - Fax:910-642-6903
Practice Address - Street 1:1345 S MADISON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4521
Practice Address - Country:US
Practice Address - Phone:910-642-2106
Practice Address - Fax:910-642-6903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0209251E00000X
NCHC0920251E00000X
NCHC0123251E00000X
NCHC0261251E00000X
NCHC3459251E00000X
NCHC0919251E00000X
NCHC3651251E00000X
NCHC3460251E00000X
251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408112Medicaid