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Organization

SPC HOME HEALTH LLC

Active
Other names
SPC Home Care
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHAKISHA NICOLE BREWINGTON (OWNER/BUSINESS MANAGER)
(910) 658-8525
Entity
Organization

Contact information

Practice address
4910 RANDALL PARKWAY, WILMINGTON, NC 28403-2827
(910) 395-8039
Mailing address
P.O. BOX 3385, WILMINGTON, NC 28406-0385
(910) 395-8039
(910) 395-8381

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4101
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6602388
NC
Enumeration date
06/03/2010
Last updated
10/12/2012
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