Organization
STAT ETC, INC.
Active
Other names
Queen City Home Care & Medical Staffing
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOLETTA WYLIE (ADMINISTRATOR)
(980) 217-5231
Entity
Organization
Contact information
Practice address
4917 ALBEMARLE RD STE 206, CHARLOTTE, NC 28205-6686
(980) 217-5231
(919) 400-4201
Mailing address
PO BOX 29562, CHARLOTTE, NC 28229-9562
(980) 217-5231
(919) 400-4201
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HC3156
NC
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418002
—
NC
05
—
6601380
—
NC
05
—
6800485
—
NC
05
—
7100577
—
NC
Enumeration date
12/12/2006
Last updated
03/13/2024
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