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General NPI Number Information
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NPI Number | 1194124362
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Entity Type | Organization
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Legal Business Name | IN-HOUSE DOC, INC
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 1123 S MAIN ST
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City | REIDSVILLE
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State | NC
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Zip | 27320-5339
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Country | US
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Telephone | 336-245-9519
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Fax | 336-245-4613
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Provider Business Mailing Address
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Address Line | 935 E MOUNTAIN ST STE M
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City | KERNERSVILLE
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State | NC
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Zip | 27284-3238
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Country | US
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Telephone | 336-245-9519
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Fax | 336-245-4613
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. FERNANDO ENRIQUE ARIZA
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Credential | MD
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Telephone | 336-245-9519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2001-01309
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | 2001-01309
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2001-01309
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License Number State | NC
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