Provider Demographics
NPI:1124112081
Name:ATLANTICARE HOME CARE AGENCY, INC
Entity type:Organization
Organization Name:ATLANTICARE HOME CARE AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:E
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-321-5510
Mailing Address - Street 1:323 CLIFTON ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5005
Mailing Address - Country:US
Mailing Address - Phone:252-321-5510
Mailing Address - Fax:252-321-5512
Practice Address - Street 1:323 CLIFTON STREET
Practice Address - Street 2:SUITE 9
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-321-5510
Practice Address - Fax:252-321-5512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2412251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health