1215000583 NPI number — COORDINATED HEALTH SERVICES, INC.

Table of content: (NPI 1215000583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215000583 NPI number — COORDINATED HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COORDINATED HEALTH SERVICES, INC.
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:
1215000583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1224 COPELAND OAKS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27560-6614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-465-0910
Provider Business Mailing Address Fax Number:
919-465-0918

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3467 AIRPORT BLVD NW STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27896-8828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-291-3000
Provider Business Practice Location Address Fax Number:
252-291-6668
Provider Enumeration Date:
11/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ENTERKIN
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
919-465-0910

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 8300336 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300336G , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300336S , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300336H , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300336B , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com