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General NPI Number Information
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NPI Number | 1942660352
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Entity Type | Organization
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Legal Business Name | FIVE POINTS HEALTHCARE OF NC, LLC
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Dates
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Enumeration Date | 02/26/2016
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Last Update Date | 02/26/2016
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Provider Practice Location Address
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Address Line | 1540 PURDUE DR SUITE 302
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-5509
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Country | US
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Telephone | 910-323-3628
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Fax | 910-323-3628
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Provider Business Mailing Address
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Address Line | 1540 PURDUE DR SUITE 302
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-5509
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Country | US
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Telephone | 910-323-3628
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Fax | 910-323-3628
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Authorized Official
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Title or Position | CEO
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Name | ROBERT A RADICS
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Credential |
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Telephone | 404-692-4417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC3421
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License Number State | NC
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