Provider Demographics
NPI:1699090761
Name:GERIATRIC VISITING PRACTITIONERS INC
Entity type:Organization
Organization Name:GERIATRIC VISITING PRACTITIONERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-845-2131
Mailing Address - Street 1:6512 SIX FORKS RD
Mailing Address - Street 2:SUITE 601A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6561
Mailing Address - Country:US
Mailing Address - Phone:919-845-2131
Mailing Address - Fax:919-845-2139
Practice Address - Street 1:6512 SIX FORKS RD
Practice Address - Street 2:SUITE 601A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6561
Practice Address - Country:US
Practice Address - Phone:919-845-2131
Practice Address - Fax:919-845-2139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8346OtherLAST FOUR