MRS. MARGARETTA HINES MOORE ADMINISTRATOR NPI 1255456380

Custodial Care Facility (Adult Care Home) in Winston Salem, NC

Individual Female Custodial Care Facility Adult Care Home

About MARGARETTA MOORE

Margaretta Moore is a provider established in Winston Salem, North Carolina and her medical specialization is custodial care facility. The NPI number of Margaretta Moore is 1255456380 and was assigned on March 2007. The practitioner's primary taxonomy code is 311ZA0620X with license number FCL 034024 (NC). The provider is registered as an individual and her NPI record was last updated 13 years ago.

NPI

1255456380

Provider NameMRS. MARGARETTA HINES MOORE ADMINISTRATOR
Provider Location Address2224 MANCHESTER ST WINSTON SALEM, NC 27105
Provider Mailing Address2224 MANCHESTER ST WINSTON SALEM, NC 27105
GenderFemale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date03-20-2007
Last Update Date07-09-2007

Primary Taxonomy

Taxonomy Code311ZA0620X
ClassificationCustodial Care Facility
TypeNursing & Custodial Care Facilities
SpecializationAdult Care Home
License No.FCL 034024
License StateNC
Taxonomy DescriptionA custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Business Address

MRS. MARGARETTA HINES MOORE ADMINISTRATOR
2224 MANCHESTER ST
WINSTON SALEM, NC
ZIP 27105
Phone: (336) 727-1308
Fax: (336) 723-8142

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Mailing Address

MRS. MARGARETTA HINES MOORE ADMINISTRATOR
2224 MANCHESTER ST
WINSTON SALEM, NC
ZIP 27105
Phone: (336) 727-1308
Fax: (336) 723-8142

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
7801419MEDICAID (05)NC

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.