Provider Demographics
NPI:1992322630
Name:MARY AND MARTHA HOLISTIC HEALTH CARE HOME HEALTH CARE
Entity type:Organization
Organization Name:MARY AND MARTHA HOLISTIC HEALTH CARE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:EVETTE
Authorized Official - Middle Name:LEMILLE
Authorized Official - Last Name:BLEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:910-496-6896
Mailing Address - Street 1:101 PIGEONHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-0244
Mailing Address - Country:US
Mailing Address - Phone:910-496-6896
Mailing Address - Fax:
Practice Address - Street 1:101 PIGEONHOUSE CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311-0244
Practice Address - Country:US
Practice Address - Phone:910-496-6896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332S00000XSuppliersHearing Aid Equipment
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)