Organization Name: | PRIMARY HEALTH CHOICE, INC. |
NPI Number: | 1114278991 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THAD DAVIS (CEO) |
Mailing Address: | 1424 S Jk Powell Blvd Ste G Whiteville |
State: | NC US |
Postal Code: | 284729145 |
Phone Number: | 9102076184 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2012 |
NPI Last Update Date: | 09/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |