Provider Demographics
NPI:1760512925
Name:PRIORITY HOME CARE AGENCY INC
Entity Type:Organization
Organization Name:PRIORITY HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:THOMPSON
Authorized Official - Last Name:SPIVEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-654-9910
Mailing Address - Street 1:3758 JOE BROWN HWY S
Mailing Address - Street 2:PO BOX 403
Mailing Address - City:CHADBOURN
Mailing Address - State:NC
Mailing Address - Zip Code:28431-9180
Mailing Address - Country:US
Mailing Address - Phone:910-654-9910
Mailing Address - Fax:910-654-0158
Practice Address - Street 1:3758 JOE BROWN HWY S
Practice Address - Street 2:
Practice Address - City:CHADBOURN
Practice Address - State:NC
Practice Address - Zip Code:28431-9180
Practice Address - Country:US
Practice Address - Phone:910-654-9910
Practice Address - Fax:910-654-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1937251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600730Medicaid
NC3409262Medicaid