Organization
ERAJ HOLDINGS, LLC
Active
Other names
Liberty Home Care V, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD B. MCNEILL (MEMBER)
(910) 815-3122
Entity
Organization
Contact information
Practice address
814 WORTH ST, MOUNT AIRY, NC 27030-4561
(336) 719-7434
(336) 719-7435
Mailing address
2334 S 41ST ST, WILMINGTON, NC 28403-5502
(910) 815-3122
(910) 815-3111
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007CH
BLUE CROSS BLUE SHIELD
NC
05
—
3407172
—
NC
Enumeration date
05/04/2009
Last updated
03/06/2018
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