Provider Demographics
NPI:1932419421
Name:MEDCARE HOSPITALITY, INC.
Entity Type:Organization
Organization Name:MEDCARE HOSPITALITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TEIJI
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMBALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-479-9777
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:BAHAMA
Mailing Address - State:NC
Mailing Address - Zip Code:27503-0356
Mailing Address - Country:US
Mailing Address - Phone:919-479-9777
Mailing Address - Fax:
Practice Address - Street 1:10910 S LOWELL RD
Practice Address - Street 2:
Practice Address - City:BAHAMA
Practice Address - State:NC
Practice Address - Zip Code:27503-8799
Practice Address - Country:US
Practice Address - Phone:919-479-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No251X00000XAgenciesSupports Brokerage
No347E00000XTransportation ServicesTransportation BrokerGroup - Multi-Specialty