Provider Demographics
NPI:1184708893
Name:LAUREL HEALTH CARE COMPANY OF CHATHAM NORTH CAROLINA, INC.
Entity type:Organization
Organization Name:LAUREL HEALTH CARE COMPANY OF CHATHAM NORTH CAROLINA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-794-8800
Mailing Address - Street 1:72 CHATHAM BUSINESS DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-5687
Mailing Address - Country:US
Mailing Address - Phone:919-542-6677
Mailing Address - Fax:919-542-1803
Practice Address - Street 1:72 CHATHAM BUSINESS DR
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5687
Practice Address - Country:US
Practice Address - Phone:919-542-6677
Practice Address - Fax:919-542-1803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0523332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0099MOtherBC/BS #
NC923099OtherFACILITY ID #
NC3415421Medicaid
NCNH0523OtherNH LICENSE #
NC3415421Medicaid