Organization
MOUNT EAGLE HEALTH CARE - CLEMMONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAHATI N SIMTAJI (DIRECTOR)
(336) 934-4227
Entity
Organization
Contact information
Practice address
2554 LEWISVILLE CLEMMONS RD # 306, CLEMMONS, NC 27012-8110
(336) 934-4227
Mailing address
2554 LEWISVILLE CLEMMONS RD # 306, CLEMMONS, NC 27012-8110
(336) 934-4227
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
HC1587
NC
253Z00000X
In Home Supportive Care Agency
HC1587
NC
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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