Provider Demographics
NPI:1295064483
Name:APB HOME HEALTH LLC
Entity type:Organization
Organization Name:APB HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAKISHA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BREWINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-658-8525
Mailing Address - Street 1:P.O. BOX 4866
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28406-1866
Mailing Address - Country:US
Mailing Address - Phone:919-963-2428
Mailing Address - Fax:919-963-2438
Practice Address - Street 1:2504 RAEFORD RD STE 106
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5135
Practice Address - Country:US
Practice Address - Phone:919-963-2428
Practice Address - Fax:919-963-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3975251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3419244Medicaid