Provider Demographics
NPI:1134414485
Name:EXCELLENT CHOICE HOME HEALTH CARE AND UNIFORM SALES
Entity type:Organization
Organization Name:EXCELLENT CHOICE HOME HEALTH CARE AND UNIFORM SALES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:BRAYBOY
Authorized Official - Last Name:LOCKLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:910-608-9503
Mailing Address - Street 1:588 BAILEY RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2455
Mailing Address - Country:US
Mailing Address - Phone:910-608-9503
Mailing Address - Fax:910-608-9508
Practice Address - Street 1:588 BAILEY RD
Practice Address - Street 2:SUITE G
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2455
Practice Address - Country:US
Practice Address - Phone:910-608-9503
Practice Address - Fax:910-608-9508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4384251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health