Provider Demographics
NPI:1639795339
Name:BLUE CROSS HOME HEALTH, INC.
Entity Type:Organization
Organization Name:BLUE CROSS HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSEYI
Authorized Official - Middle Name:OLUMUYIWA
Authorized Official - Last Name:LOJEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-696-2119
Mailing Address - Street 1:4728 LONNIE DR
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-8747
Mailing Address - Country:US
Mailing Address - Phone:919-696-2119
Mailing Address - Fax:
Practice Address - Street 1:1008 BULLARD CT STE 202
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6833
Practice Address - Country:US
Practice Address - Phone:919-696-2119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care