Healthcare Provider Details

I. General information

NPI: 1265664684
Provider Name (Legal Business Name): PRIVATE HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2009
Last Update Date: 08/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 BUCKLEIGH DR
CHARLOTTE NC
28215-7544
US

IV. Provider business mailing address

2600 BUCKLEIGH DR
CHARLOTTE NC
28215-7544
US

V. Phone/Fax

Practice location:
  • Phone: 704-301-4164
  • Fax:
Mailing address:
  • Phone: 704-301-4164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TONIE ROSALYN GREGG-HUTCHISON
Title or Position: CEO/OWNER
Credential:
Phone: 704-301-4164