Organization
PROFESSIONAL CARE HOME HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESIA MEDLEY (ADMINISTRATOR)
(704) 536-7326
Entity
Organization
Contact information
Practice address
2070 CLOVERDALE AVE, SUITE C, WINSTON-SALEM, NC 27103-2503
(336) 725-0755
Mailing address
2070 CLOVERDALE AVE, SUITE C, WINSTON-SALEM, NC 27103-2503
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5555555
DME-WINSTON-SALEM
—
Enumeration date
10/16/2008
Last updated
10/16/2008
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