Healthcare Provider Details

I. General information

NPI: 1922292929
Provider Name (Legal Business Name): TRIANGLE MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2007
Last Update Date: 09/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2921 DAMASCUS RD
FAYETTEVILLE NC
28303-4662
US

IV. Provider business mailing address

2921 DAMASCUS RD
FAYETTEVILLE NC
28303-4662
US

V. Phone/Fax

Practice location:
  • Phone: 910-222-0029
  • Fax: 910-222-0031
Mailing address:
  • Phone: 910-222-0029
  • Fax: 910-222-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIET SOUTHERLAND
Title or Position: DIRECTOR
Credential:
Phone: 910-222-0029