1396096814 NPI number — POSITIVE CARE SOLUTIONS INCORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396096814 NPI number — POSITIVE CARE SOLUTIONS INCORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POSITIVE CARE SOLUTIONS INCORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396096814
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5108 REAGAN DR
Provider Second Line Business Mailing Address:
SUITE 10
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28206-3103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-716-1155
Provider Business Mailing Address Fax Number:
704-716-1152

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5108 REAGAN DR
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28206-3103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-716-1155
Provider Business Practice Location Address Fax Number:
704-716-1152
Provider Enumeration Date:
09/24/2012

Additional Information

Authorized Official

Authorized Official Last Name:
VISER
Authorized Official First Name:
ALBERTINE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER/DIRECTOR
Authorized Official Telephone Number:
980-328-2492

Provider Taxonomy Codes

  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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