Provider Demographics
NPI:1659327633
Name:CALDWELL HOME SERVICES INC
Entity Type:Organization
Organization Name:CALDWELL HOME SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GUESS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-728-0168
Mailing Address - Street 1:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638
Mailing Address - Country:US
Mailing Address - Phone:828-728-0168
Mailing Address - Fax:828-728-0169
Practice Address - Street 1:1822 HICKORY BLVD SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645
Practice Address - Country:US
Practice Address - Phone:828-728-0168
Practice Address - Fax:828-728-0169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3482251E00000X
NC01155332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418309Medicaid
NC01155OtherDME
NC6601571Medicaid
NC7704568Medicaid
NC6601571Medicaid