Provider Demographics
NPI:1023154994
Name:MATTHEWS FAMILY HOME CARE, INC.
Entity type:Organization
Organization Name:MATTHEWS FAMILY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THERL
Authorized Official - Middle Name:RAYNARD
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-898-4998
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:GOLDSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27252-0545
Mailing Address - Country:US
Mailing Address - Phone:919-898-4998
Mailing Address - Fax:919-898-4970
Practice Address - Street 1:452 BELLEVUE STREET
Practice Address - Street 2:
Practice Address - City:GOLDSTON
Practice Address - State:NC
Practice Address - Zip Code:27252-0545
Practice Address - Country:US
Practice Address - Phone:919-898-4998
Practice Address - Fax:919-898-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3166251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418022OtherLEVEL II
NC6601379Medicaid