Provider Demographics
NPI:1669557534
Name:VICTORY OF FAITH HOME HEALTHCARE INC
Entity type:Organization
Organization Name:VICTORY OF FAITH HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HATTIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-356-4982
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:COFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27922-0159
Mailing Address - Country:US
Mailing Address - Phone:252-356-1165
Mailing Address - Fax:252-356-2374
Practice Address - Street 1:1033 HWY 45 SOUTH
Practice Address - Street 2:
Practice Address - City:COFIELD
Practice Address - State:NC
Practice Address - Zip Code:27922
Practice Address - Country:US
Practice Address - Phone:252-356-1165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600589Medicaid
NC3401970Medicaid