Provider Demographics
NPI:1861700262
Name:MYLES HOME HEALTH AGENCY
Entity type:Organization
Organization Name:MYLES HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MYLES
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-206-1112
Mailing Address - Street 1:PO BOX 4696
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-0696
Mailing Address - Country:US
Mailing Address - Phone:252-206-1112
Mailing Address - Fax:
Practice Address - Street 1:210 NASH ST S
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3885
Practice Address - Country:US
Practice Address - Phone:252-206-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health