- Enrollment id
- O20170524002612
- Enrollment state
- NC
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1831634179
- Multiple npi flag
- N
- Ccn
- 341600
- Associate id
- 3072815091
- Organization name
- MSA HOME HEALTH AND HOSPICE OF NC, INC
- Doing business as name
- MEDI HOME HOSPICE
- Incorporation date
- 2015-09-08
- Incorporation state
- NC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 564 W MCLEAN ST
- Address line 2
- STE B
- City
- SAINT PAULS
- State
- NC
- Zip code
- 283841421