Healthcare Provider Details

I. General information

NPI: 1609188697
Provider Name (Legal Business Name): COORDINATED HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N ROBERTS AVE
LUMBERTON NC
28358-2279
US

IV. Provider business mailing address

1224 COPELAND OAKS DR
MORRISVILLE NC
27560-6614
US

V. Phone/Fax

Practice location:
  • Phone: 910-618-1766
  • Fax: 910-618-1768
Mailing address:
  • Phone: 919-465-0910
  • Fax: 919-465-0918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY S JENKINS
Title or Position: CEO
Credential:
Phone: 919-465-0910