Provider Demographics
NPI:1598001638
Name:AAA HOMECARE
Entity Type:Organization
Organization Name:AAA HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-366-6475
Mailing Address - Street 1:600 FARRINGDOM ST STE E
Mailing Address - Street 2:SUITE E
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2683
Mailing Address - Country:US
Mailing Address - Phone:910-366-6475
Mailing Address - Fax:
Practice Address - Street 1:600 FARRINGDOM ST STE E
Practice Address - Street 2:SUITE E
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2683
Practice Address - Country:US
Practice Address - Phone:910-366-6475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4515251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health