Provider Demographics
NPI:1972229631
Name:SURECARE HOMECARE
Entity type:Organization
Organization Name:SURECARE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZENOBIA
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:BRACK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:908-249-1334
Mailing Address - Street 1:819 W RALEIGH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-2764
Mailing Address - Country:US
Mailing Address - Phone:919-879-3132
Mailing Address - Fax:919-585-7377
Practice Address - Street 1:819 W RALEIGH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-2764
Practice Address - Country:US
Practice Address - Phone:908-249-1334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care