Healthcare Provider Details

I. General information

NPI: 1336704626
Provider Name (Legal Business Name): HEALTH SYSTEM SERVICES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 WEDDINGTON RD NW
CONCORD NC
28027-3412
US

IV. Provider business mailing address

6867 WILLIAMS RD
NIAGARA FALLS NY
14304-2993
US

V. Phone/Fax

Practice location:
  • Phone: 704-782-4338
  • Fax: 704-782-6155
Mailing address:
  • Phone: 716-283-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MINICUCCI
Title or Position: PRESIDENT
Credential:
Phone: 716-283-2339