Healthcare Provider Details
I. General information
NPI: 1922270214
Provider Name (Legal Business Name): ASD-CAP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 N DUKE ST SUITE 103
DURHAM NC
27704-1709
US
IV. Provider business mailing address
8430 UNIVERSITY EXEC PARK DR STE 655
CHARLOTTE NC
28262-1300
US
V. Phone/Fax
- Phone: 919-471-1800
- Fax: 919-471-1877
- Phone: 704-549-1659
- Fax: 704-549-1664
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | HC1308 |
| License Number State | NC |
VIII. Authorized Official
Name: MRS.
VERONICA
K
MCLENDON
Title or Position: VICE PRESIDENT
Credential:
Phone: 704-549-1659