Organization
PELHAM HOME HEALTH SERVICES, INC
Active
Other names
PELHAM HOME HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
MILDRED C WILSON RN, BSN (ADMINISTRATOR)
(910) 630-6757
Entity
Organization
Contact information
Practice address
949 COUNTRY CLUB DR, FAYETTEVILLE, NC 28301-2907
(910) 630-6757
(910) 884-9806
Mailing address
949 COUNTRY CLUB DR, FAYETTEVILLE, NC 28301-2907
(910) 630-6757
(910) 884-9806
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC1859
NC
251E00000X
Home Health Agency
HC2268
NC
251E00000X
Home Health Agency
HC2303
NC
251E00000X
Home Health Agency
HC2838
NC
251E00000X
Home Health Agency
HC3189
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409245
—
NC
05
—
6600697
—
NC
05
—
6600905
—
NC
05
—
6600918
—
NC
05
—
6601211
—
NC
05
—
6601406
—
NC
Enumeration date
11/13/2006
Last updated
05/25/2012
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