Provider Demographics
NPI:1528071222
Name:HOME CARE PHARMACY INC NC
Entity type:Organization
Organization Name:HOME CARE PHARMACY INC NC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:STANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-572-4274
Mailing Address - Street 1:5037 HALIFAX ROAD
Mailing Address - Street 2:PO BOX 1070 STE N
Mailing Address - City:HALIFAX
Mailing Address - State:VA
Mailing Address - Zip Code:24553-3185
Mailing Address - Country:US
Mailing Address - Phone:434-572-4274
Mailing Address - Fax:434-572-6889
Practice Address - Street 1:104 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4027
Practice Address - Country:US
Practice Address - Phone:800-948-3918
Practice Address - Fax:919-775-1360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC05976332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC03953OtherBCBS
NC7702061Medicaid
NC7702061Medicaid