Healthcare Provider Details

I. General information

NPI: 1841887676
Provider Name (Legal Business Name): CAO HEALTH SYSTEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2020
Last Update Date: 12/28/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2016 CREEKSIDE LANDING DR
APEX NC
27502-3982
US

IV. Provider business mailing address

2016 CREEKSIDE LANDING DR
APEX NC
27502-3982
US

V. Phone/Fax

Practice location:
  • Phone: 919-213-9134
  • Fax:
Mailing address:
  • Phone: 919-213-9134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: LUCAS WILKERSON
Title or Position: REGISTERED DIETITIAN
Credential: RDN, LDN
Phone: 336-267-0065