Healthcare Provider Details

I. General information

NPI: 1801218532
Provider Name (Legal Business Name): RGM HOLDINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1606 E ROOSEVELT BLVD STE 109
MONROE NC
28112-4049
US

IV. Provider business mailing address

1606 E ROOSEVELT BLVD STE 109
MONROE NC
28112-4049
US

V. Phone/Fax

Practice location:
  • Phone: 704-726-6848
  • Fax: 704-943-9148
Mailing address:
  • Phone: 704-726-6848
  • Fax: 704-943-9148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number706
License Number StateNC

VIII. Authorized Official

Name: MR. ROBERT GARRETT MCCOY JR.
Title or Position: OWNER
Credential: BC-HIS
Phone: 704-726-6848