Genuwinepersonalcare

LBN: Genuwinepersonalcare
Genuwinepersonalcare is an health care organization with primary practice located at 3305 Stockton St , Winston Salem NC 27127-5135. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Genuwinepersonalcare can be contacted via phone (336) 499-7113, or through Williams, Audrey Jean via phone (336) 499-7113.

Contact Information

Primary practice address
3305 Stockton St Winston Salem NC 27127-5135
Fax: (336) 650-1057
Website:
Authorized official contact:
Name: Williams, Audrey Jean

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X North Carolina

Profile Details

NPI number 1508902701
LBN Legal business name Genuwinepersonalcare
DBA Doing business as
Authorized official Williams, Audrey Jean
Entity Organization
Organization subpart 1 No
Enumeration date Jan 29th, 2007
Last updated Jul 16th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508902701 NPPES
North Carolina MEDICAID 3408562
North Carolina MEDICAID 8301733
North Carolina MEDICAID 8301526

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