Provider Demographics
NPI:1538042510
Name:INTERCARE
Entity type:Organization
Organization Name:INTERCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAKONYONGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-724-9141
Mailing Address - Street 1:2880 NORTHCROSS DR
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-6710
Mailing Address - Country:US
Mailing Address - Phone:919-724-9141
Mailing Address - Fax:
Practice Address - Street 1:2880 NORTHCROSS DR
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-6710
Practice Address - Country:US
Practice Address - Phone:919-724-9141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker