1912453259 NPI number — PERFECT CARE SOLUTIONS INC

Table of content: (NPI 1912453259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912453259 NPI number — PERFECT CARE SOLUTIONS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERFECT CARE SOLUTIONS 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:
1912453259
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PERFECT CARE SOLUTIONS 5916 BRAINERD RD SUITE 101
Provider Second Line Business Mailing Address:
5916 BRAINERD RD SUITE 101
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AA
Provider Business Mailing Address Postal Code:
37421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-702-5134
Provider Business Mailing Address Fax Number:
423-702-5269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5916 BRAINERD RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37421-3524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-702-5134
Provider Business Practice Location Address Fax Number:
423-702-5269
Provider Enumeration Date:
08/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ONGAU
Authorized Official First Name:
EUCABETH
Authorized Official Middle Name:
NYASUGUTA
Authorized Official Title or Position:
EXECUTIVE DIRECTOR/OWNER
Authorized Official Telephone Number:
862-200-4024

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  1000000014391 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com