Provider Demographics
NPI:1154697266
Name:HEALTHCORE RESOURCE INC
Entity type:Organization
Organization Name:HEALTHCORE RESOURCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IJEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-872-1178
Mailing Address - Street 1:1001 NAVAHO DR STE 210
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7318
Mailing Address - Country:US
Mailing Address - Phone:919-872-1178
Mailing Address - Fax:919-872-1170
Practice Address - Street 1:1831 WEEKSVILLE RD
Practice Address - Street 2:SUITE L
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-7721
Practice Address - Country:US
Practice Address - Phone:919-872-1178
Practice Address - Fax:919-872-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health