Provider Demographics
NPI:1730248683
Name:GOOD SHEPHERD HOME HEALTH CARE INC.
Entity type:Organization
Organization Name:GOOD SHEPHERD HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:ARRINGTON
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DD
Authorized Official - Phone:252-442-3000
Mailing Address - Street 1:935 TARBORO ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-5961
Mailing Address - Country:US
Mailing Address - Phone:252-442-3000
Mailing Address - Fax:252-442-3065
Practice Address - Street 1:148 S. WASHINGTON ST. HARAMBEE SQ.
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-5961
Practice Address - Country:US
Practice Address - Phone:252-442-3000
Practice Address - Fax:252-442-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3542251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health