Healthcare Provider Details
I. General information
NPI: 1922251909
Provider Name (Legal Business Name): AURORASUPPORTSERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2008
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
114 SOUTH MAIN ST
HIGHPOINT NC
27262
US
IV. Provider business mailing address
2108 CANDELAR DR
HIGHPOINT NC
27265
US
V. Phone/Fax
- Phone: 336-259-0528
- Fax: 336-841-2323
- Phone: 336-259-0528
- Fax: 336-841-2323
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MUNAZZA
TABASSUM
RAHIM
Title or Position: PRESIDENT
Credential:
Phone: 336-259-0528