Healthcare Provider Details

I. General information

NPI: 1164881611
Provider Name (Legal Business Name): FIDELITY HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2327 ENGLERT DR SUITE 306
DURHAM NC
27713-4446
US

IV. Provider business mailing address

4535 N ROXBORO ST
DURHAM NC
27704-1831
US

V. Phone/Fax

Practice location:
  • Phone: 919-316-7770
  • Fax: 919-316-7772
Mailing address:
  • Phone: 919-306-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC4098
License Number StateNC

VIII. Authorized Official

Name: DR. JIM OSITA OKEKE
Title or Position: CEO
Credential: D.O
Phone: 919-201-8914