Provider Demographics
NPI:1215072558
Name:NEIGHBORHOOD NURSES HEALTH CARE SERVICES INC
Entity type:Organization
Organization Name:NEIGHBORHOOD NURSES HEALTH CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PENNIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-292-1234
Mailing Address - Street 1:1821 N ROCKY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-7961
Mailing Address - Country:US
Mailing Address - Phone:704-292-1234
Mailing Address - Fax:704-292-1112
Practice Address - Street 1:1821 N ROCKY RIVER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7961
Practice Address - Country:US
Practice Address - Phone:704-292-1234
Practice Address - Fax:704-292-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC22393747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409487Medicaid