Provider Demographics
NPI:1679554604
Name:REGIONAL IN-HOME HEALTH CARE INC
Entity type:Organization
Organization Name:REGIONAL IN-HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:B
Authorized Official - Last Name:FLEETWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-585-3667
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NC
Mailing Address - Zip Code:27820-0327
Mailing Address - Country:US
Mailing Address - Phone:252-585-3667
Mailing Address - Fax:252-585-0788
Practice Address - Street 1:114 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NC
Practice Address - Zip Code:27820-0327
Practice Address - Country:US
Practice Address - Phone:252-585-3667
Practice Address - Fax:252-585-0788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1651251J00000X
NCHC2198251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408967Medicaid
NC6600578Medicaid
NC6600856Medicaid