=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245543388
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASSURED HEALTH MONITORING SYSTEMS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2010
-----------------------------------------------------
Last Update Date | 07/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11330 VANSTORY DR SUITE 109E
-----------------------------------------------------
City | HUNTERSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28078-8143
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-562-6439
-----------------------------------------------------
Fax | 704-875-1877
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 295 SEVEN FARMS DR SUITE C-163
-----------------------------------------------------
City | DANIEL ISLAND
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29492-8001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-562-6439
-----------------------------------------------------
Fax | 704-875-1877
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER/MANAGER
-----------------------------------------------------
Name | EVA ULLO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 704-562-6439
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333300000X
-----------------------------------------------------
Taxonomy Name | Emergency Response System Companies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------