Provider Demographics
NPI:1962698084
Name:IMPACT HEALTH SOLUTIONS INC
Entity type:Organization
Organization Name:IMPACT HEALTH SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VIOLET
Authorized Official - Middle Name:IFEOMA
Authorized Official - Last Name:SMART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-400-6144
Mailing Address - Street 1:3535 S WILMINGTON ST STE 204B
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-3512
Mailing Address - Country:US
Mailing Address - Phone:919-400-6144
Mailing Address - Fax:919-779-5244
Practice Address - Street 1:3535 S WILMINGTON ST STE 204B
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3512
Practice Address - Country:US
Practice Address - Phone:919-400-6144
Practice Address - Fax:917-779-5244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NCHC3151251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCFACILITY ID 051001OtherNC DHHS