MEDICARE: PBM HEALTH SERVICES CONSULTING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency		NC
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1174853493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PBM HEALTH SERVICES CONSULTING

Provider Business Mailing Address
First Line	:	4819 EMPEROR BLVD
Second Line	:	STE 400
City	:	DURHAM
State	:	NC
Zip	:	27703-5420
Country	:	US
Telephone Number	:	919-313-4816
Fax Number	:	919-313-4819

Provider Business Practice Location Address
First Line	:	4819 EMPEROR BLVD
Second Line	:	STE 400
City	:	DURHAM
State	:	NC
Zip	:	27703-5420
Country	:	US
Telephone Number	:	919-313-4816
Fax Number	:	919-313-4819

Authorized Official
Title or Position	:	CEO
Name	:	MS. BERNADETTE V COOPER
Credential	:	RN, BSN, CCM, MBA
Telephone Number	:	919-225-5037

Provider Enumeration Date	:	01/08/2010
Last Update Date	:	01/08/2010

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Directions to “PBM HEALTH SERVICES CONSULTING ” Practice Location

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