Provider Demographics
NPI:1194903823
Name:TRIAD. HOME CARE, INC
Entity type:Organization
Organization Name:TRIAD. HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-725-3815
Mailing Address - Street 1:1020 BROOKSTOWN AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2539
Mailing Address - Country:US
Mailing Address - Phone:336-725-3815
Mailing Address - Fax:336-725-3815
Practice Address - Street 1:1020 BROOKSTOWN AVE STE 4
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2539
Practice Address - Country:US
Practice Address - Phone:336-725-3815
Practice Address - Fax:336-725-3815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health