Provider Demographics
NPI:1588037980
Name:MSA HOME HEALTH AND HOSPICE OF NC INC
Entity Type:Organization
Organization Name:MSA HOME HEALTH AND HOSPICE OF NC INC
Other - Org Name:ALBEMARLE HOME CARE AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JEFFCOAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-957-0500
Mailing Address - Street 1:PO BOX 1928
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29071-1928
Mailing Address - Country:US
Mailing Address - Phone:803-957-0500
Mailing Address - Fax:888-342-6190
Practice Address - Street 1:1507 N ROAD ST STE 2
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3283
Practice Address - Country:US
Practice Address - Phone:252-338-4066
Practice Address - Fax:252-338-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1588037980Medicaid
NC347017Medicare Oscar/Certification