Provider Demographics
NPI:1992856082
Name:WARM HOME HEALTHCARE AGENCY, INC.
Entity Type:Organization
Organization Name:WARM HOME HEALTHCARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:TANKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-596-2706
Mailing Address - Street 1:919 JEROME RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1246
Mailing Address - Country:US
Mailing Address - Phone:919-596-2706
Mailing Address - Fax:919-287-2339
Practice Address - Street 1:919 JEROME RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1246
Practice Address - Country:US
Practice Address - Phone:919-596-2706
Practice Address - Fax:919-287-2339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3511251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601581Medicaid