Organization
PROFESSIONAL CARE HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESIA MEDLEY (ADMINISTRATOR)
(704) 536-7326
Entity
Organization
Contact information
Practice address
3137 AMITY COURT, SUITE 400, CHARLOTTE, NC 28215-5765
(704) 536-7326
(704) 536-7147
Mailing address
3137 AMITY COURT, SUITE 400, CHARLOTTE, NC 28215-5765
(704) 536-7326
(704) 536-7147
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
NC
Enumeration date
01/06/2009
Last updated
01/06/2009
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