Organization
HOMECARE MEDICAL GROUPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOSHA TYSON CPED, CFM, BS (REPRESENTATIVE)
(866) 415-4210
Entity
Organization
Contact information
Practice address
10429 LIGON MILL RD, WAKE FOREST, NC 27587-4987
(866) 415-4210
Mailing address
PO BOX 1893, WAKE FOREST, NC 27588-1893
(866) 415-4210
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
01782
NC
Other
Enumeration date
05/17/2011
Last updated
05/17/2011
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