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General NPI Number Information
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NPI Number | 1649666876
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Entity Type | Organization
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Legal Business Name | WORTHINGTON HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 818 W TERRELL ST
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City | GREENSBORO
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State | NC
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Zip | 27406-2750
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Country | US
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Telephone | 336-965-0153
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Fax |
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Provider Business Mailing Address
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Address Line | 4104 SACRAMENTO DR
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City | GREENSBORO
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State | NC
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Zip | 27406-6323
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Country | US
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Telephone | 336-965-0153
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Fax |
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Authorized Official
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Title or Position | REPRESENTATIVE
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Name | MARSHALL WORTHINGTON
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Credential |
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Telephone | 336-965-0153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 263875
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 263875
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | 263875
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 263875
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 263875
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 263875
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License Number State | NC
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Taxonomy #7
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 263875
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License Number State | NC
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