Provider Demographics
NPI:1528071453
Name:AMERICARE HEALTH
Entity type:Organization
Organization Name:AMERICARE HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IYORE
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:OJOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-399-2677
Mailing Address - Street 1:6023 BEATTIES FORD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-2205
Mailing Address - Country:US
Mailing Address - Phone:704-399-2677
Mailing Address - Fax:704-393-6522
Practice Address - Street 1:6023 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-2205
Practice Address - Country:US
Practice Address - Phone:704-399-2677
Practice Address - Fax:704-393-6522
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
NC207Q00000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014RGMedicaid
NC014RGOtherBLUECROSSBLUESHIELD ID
NC014RGOtherBLUECROSSBLUESHIELD ID