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General NPI Number Information
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NPI Number | 1164881611
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Entity Type | Organization
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Legal Business Name | FIDELITY HEALTHCARE SERVICES
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 2327 ENGLERT DR SUITE 306
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City | DURHAM
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State | NC
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Zip | 27713-4446
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Country | US
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Telephone | 919-316-7770
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Fax | 919-316-7772
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Provider Business Mailing Address
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Address Line | 4535 N ROXBORO ST
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City | DURHAM
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State | NC
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Zip | 27704-1831
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Country | US
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Telephone | 919-306-7770
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JIM OSITA OKEKE
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Credential | D.O
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Telephone | 919-201-8914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC4098
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License Number State | NC
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