Healthcare Provider Details
I. General information
NPI: 1225210347
Provider Name (Legal Business Name): ARDENT ANCILLARY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2007
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
624 HOLLY SPRINGS RD #404
HOLLY SPRINGS NC
27540-9030
US
IV. Provider business mailing address
624 HOLLY SPRINGS RD #404
HOLLY SPRINGS NC
27540-9030
US
V. Phone/Fax
- Phone: 919-608-9123
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
SPRENGER
Title or Position: MANAGER
Credential:
Phone: 919-608-9123