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Organization

MOUNT EAGLE HEALTH CARE GREENSBORO, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOROTHY SHALLUA (DIRECTOR)
(336) 283-5191
Entity
Organization

Contact information

Practice address
6000 MUSEUM DR BLDG A, WINSTON SALEM, NC 27105-9503
(336) 283-5191
(336) 499-6532
Mailing address
1 CENTERVIEW DR STE 203B, GREENSBORO, NC 27407-3712
(336) 283-5191
(336) 499-6532

Taxonomy

Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
HC2369
NC
251J00000X
Nursing Care Agency
Primary
HC2369
NC
253Z00000X
In Home Supportive Care Agency
HC2369
NC

Other

Enumeration date
10/29/2015
Last updated
10/29/2015
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