JAMIE R. KIRBY
Adult Care Home
Connellys Springs, North Carolina
Provider NPI: 1235341728
Organization Information:Organization Name: JAMIE R. KIRBY
Practice Location:
3208 TEX'S FISH CAMP ROAD CONNELLYS SPRINGS, NC 28612 US
Tel: 828-397-6090 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
3208 TEX'S FISH CAMP ROAD CONNELLYS SPRINGS, NC 28612 US
Tel: 828-397-6090 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311ZA0620X | Nursing & Custodial Care Facilities Custodial Care Facility Adult Care Home | NC | FCL012033 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
MEDICAID PROVIDER NUMBER | 7806180 | NC | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin