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General NPI Number Information
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NPI Number | 1366088460
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Entity Type | Organization
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Legal Business Name | PREFERRED HEALTH SOLUTIONS
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Dates
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Enumeration Date | 11/23/2019
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 120 SHOAL CREEK CIR
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City | LEXINGTON
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State | SC
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Zip | 29072-7262
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Country | US
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Telephone | 866-757-7333
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Fax | 800-720-5171
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Provider Business Mailing Address
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Address Line | 120 SHOAL CREEK CIR
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City | LEXINGTON
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State | SC
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Zip | 29072-7262
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Country | US
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Telephone | 866-757-7333
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Fax | 800-720-5171
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUKUDZO D MAZAIWANA
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Credential | M.D.
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Telephone | 866-757-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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