Provider Demographics
NPI:1942423413
Name:JAMAR HOME CARE AGENCY INC
Entity Type:Organization
Organization Name:JAMAR HOME CARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAFARR
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-791-5766
Mailing Address - Street 1:500 E MILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5358
Mailing Address - Country:US
Mailing Address - Phone:919-606-1656
Mailing Address - Fax:919-596-3524
Practice Address - Street 1:2524 NC HWY 55
Practice Address - Street 2:RM 7
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1369
Practice Address - Country:US
Practice Address - Phone:919-606-1656
Practice Address - Fax:919-596-3524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3348251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3416121OtherCAP PROVIDER NUMBER