Organization
CLEVELAND HOME HEALTH AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETE MOORE CEO (CHIEF EXECUTIVE OFFICER)
(704) 487-5225
Entity
Organization
Contact information
Practice address
105 T R HARRIS DR, SHELBY, NC 28150-3486
(704) 487-5225
(704) 484-4590
Mailing address
105 T R HARRIS DR, SHELBY, NC 28150-3486
(704) 487-5225
(704) 484-4590
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
HC0042
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0499G
HME
NC
05
—
7700418
—
NC
Enumeration date
11/01/2005
Last updated
08/22/2020
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