Provider Demographics
NPI:1366570491
Name:INFINITY & PASSION HOME HEALTHCARE INC
Entity type:Organization
Organization Name:INFINITY & PASSION HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OXENDINE
Authorized Official - Suffix:
Authorized Official - Credentials:CRT RCP
Authorized Official - Phone:910-521-7518
Mailing Address - Street 1:303 EAST 3RD STREET
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372
Mailing Address - Country:US
Mailing Address - Phone:910-521-7518
Mailing Address - Fax:910-521-7520
Practice Address - Street 1:303 E 3RD ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-7991
Practice Address - Country:US
Practice Address - Phone:910-521-7518
Practice Address - Fax:910-521-7520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3722251E00000X
251F00000X, 332B00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704816Medicaid
NC7704816Medicaid