Provider Demographics
NPI:1588235238
Name:UNION HOME CARE INC
Entity Type:Organization
Organization Name:UNION HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEDERICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-883-2546
Mailing Address - Street 1:1434 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-4110
Mailing Address - Country:US
Mailing Address - Phone:252-883-2546
Mailing Address - Fax:
Practice Address - Street 1:1434 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-4110
Practice Address - Country:US
Practice Address - Phone:252-883-2546
Practice Address - Fax:252-557-3541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-04
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC6110Medicaid