1689778292 NPI number — PREFERRED ALTERNATIVES, INC.

Table of content: (NPI 1689778292)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689778292 NPI number — PREFERRED ALTERNATIVES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREFERRED ALTERNATIVES, 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:
1689778292
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:
941 S MCPHERSON CHURCH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28303-5369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-483-5744
Provider Business Mailing Address Fax Number:
910-483-5494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
941 S MCPHERSON CHURCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28303-5369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-483-5744
Provider Business Practice Location Address Fax Number:
910-483-5494
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
910-483-5744

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HC1637 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8300095 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300845 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300514 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300376 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600608 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8301005 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300511 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3408791 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8300979 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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