Provider Demographics
NPI:1730358631
Name:PAT'S CARE HOME AGENCY, INC.
Entity type:Organization
Organization Name:PAT'S CARE HOME AGENCY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-215-5533
Mailing Address - Street 1:PO BOX 3217
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-3217
Mailing Address - Country:US
Mailing Address - Phone:910-215-5533
Mailing Address - Fax:910-215-5523
Practice Address - Street 1:325 PAGE RD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8751
Practice Address - Country:US
Practice Address - Phone:910-215-5533
Practice Address - Fax:910-215-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2571251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408095OtherCAP
NC6601110Medicaid