Healthcare Provider Details

I. General information

NPI: 1043759277
Provider Name (Legal Business Name): INTELLICHOICE STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1922 TRADD CT
WILMINGTON NC
28401-6637
US

IV. Provider business mailing address

1922 TRADD CT
WILMINGTON NC
28401-6637
US

V. Phone/Fax

Practice location:
  • Phone: 910-400-3000
  • Fax:
Mailing address:
  • Phone: 910-400-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHC4880
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN SEYLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 252-215-5656