Healthcare Provider Details

I. General information

NPI: 1396824884
Provider Name (Legal Business Name): XEON ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W POLLOCK ST STE 2
MOUNT OLIVE NC
28365-2000
US

IV. Provider business mailing address

100 W. POLLOCK STREET STE 2
MT. OLIVE NC
28365-2000
US

V. Phone/Fax

Practice location:
  • Phone: 919-658-0500
  • Fax: 919-658-5599
Mailing address:
  • Phone: 919-658-0500
  • Fax: 919-658-5599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHC2545
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberHC-2545
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC-2545
License Number StateNC

VIII. Authorized Official

Name: MR. VICTOR BOYD
Title or Position: DIRECTOR
Credential:
Phone: 919-658-0500