Provider Demographics
NPI:1972620144
Name:WADESBORO HOME CARE INC
Entity Type:Organization
Organization Name:WADESBORO HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-694-2768
Mailing Address - Street 1:PO BOX 1399
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-1399
Mailing Address - Country:US
Mailing Address - Phone:704-694-2768
Mailing Address - Fax:
Practice Address - Street 1:108 S GREEN ST
Practice Address - Street 2:SUITE B
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2781
Practice Address - Country:US
Practice Address - Phone:704-694-2768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health