Healthcare Provider Details

I. General information

NPI: 1295291383
Provider Name (Legal Business Name): SOLACE BIZ, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 COX AVE
THOMASVILLE NC
27360-2943
US

IV. Provider business mailing address

802 COX AVE
THOMASVILLE NC
27360-2943
US

V. Phone/Fax

Practice location:
  • Phone: 336-460-5419
  • Fax:
Mailing address:
  • Phone: 336-460-5419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: SANDRA TERESA CANTY
Title or Position: CEO
Credential: PRINCIPAL OWNER
Phone: 336-460-5419