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General NPI Number Information
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NPI Number | 1619411592
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Entity Type | Organization
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Legal Business Name | INFINIUM HEALTH SERVICES LLC
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Dates
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Enumeration Date | 12/12/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 10130 MALLARD CREEK RD SUITE 200
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City | CHARLOTTE
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State | NC
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Zip | 28262-6000
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Country | US
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Telephone | 704-944-5575
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Fax | 704-944-5578
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Provider Business Mailing Address
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Address Line | 10130 MALLARD CREEK RD SUITE 200
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City | CHARLOTTE
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State | NC
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Zip | 28262-6000
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Country | US
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Telephone | 704-944-5575
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Fax | 704-944-5578
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Authorized Official
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Title or Position | PRESIDENT/MANAGER
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Name | MARCIA A GILREATH
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Credential |
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Telephone | 704-944-5575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HC4868
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License Number State | NC
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