Provider Demographics
NPI:1710167499
Name:DOWN EAST HOME CARE AGENCY INC
Entity Type:Organization
Organization Name:DOWN EAST HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALFREDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:BS BUSINESS ADMIN
Authorized Official - Phone:252-794-1385
Mailing Address - Street 1:PO BOX 613
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-0613
Mailing Address - Country:US
Mailing Address - Phone:252-794-1385
Mailing Address - Fax:252-794-8585
Practice Address - Street 1:204 US HWY 13 17 SOUTH
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-0613
Practice Address - Country:US
Practice Address - Phone:252-794-1385
Practice Address - Fax:252-794-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3247251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601444Medicaid