Provider Demographics
NPI:1053394775
Name:TWIN STATE HOME HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:TWIN STATE HOME HEALTHCARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STERLING
Authorized Official - Middle Name:G
Authorized Official - Last Name:KOONCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-653-3136
Mailing Address - Street 1:218 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TABOR CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28463-1904
Mailing Address - Country:US
Mailing Address - Phone:910-653-3136
Mailing Address - Fax:910-653-5517
Practice Address - Street 1:218 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TABOR CITY
Practice Address - State:NC
Practice Address - Zip Code:28463-1904
Practice Address - Country:US
Practice Address - Phone:910-653-3136
Practice Address - Fax:910-653-5517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7700238Medicaid
SCDME031Medicaid
NC1053394775Medicare NSC