Provider Demographics
NPI:1700452323
Name:ALBERTACARE, LLC
Entity Type:Organization
Organization Name:ALBERTACARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARSHIA
Authorized Official - Middle Name:MCCRAY
Authorized Official - Last Name:PULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-916-7783
Mailing Address - Street 1:2601 EXTON WOODS DR APT 109
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6885
Mailing Address - Country:US
Mailing Address - Phone:919-916-7783
Mailing Address - Fax:
Practice Address - Street 1:9121 ANSON WAY STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5857
Practice Address - Country:US
Practice Address - Phone:919-916-7783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care