Provider Demographics
NPI:1427254176
Name:ON-SIGHT CONTINENCE CARE LLC
Entity type:Organization
Organization Name:ON-SIGHT CONTINENCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FORBIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-985-1371
Mailing Address - Street 1:PO BOX 7396
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-0396
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2022 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 305
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6808
Practice Address - Country:US
Practice Address - Phone:252-985-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALDG7431OtherRR MEDICARE GROUP
ALDG7431OtherRR MEDICARE GROUP