Prosource Therapeutics Llc

LBN: Prosource Therapeutics Llc
Prosource Therapeutics Llc is an health care organization with primary practice located at 102 Fox Haven Dr Suite A, Greenville NC 27858-7100. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as the primary health care specialty. Prosource Therapeutics Llc can be contacted via phone (252) 353-7025, or through Smith, Phyllis Saunders via phone (252) 353-7025.

Contact Information

Primary practice address
102 Fox Haven Dr Suite A Greenville NC 27858-7100
Phone: (252) 353-7025
Fax: (252) 353-7028
Website:
Map and Directions
Authorized official contact:
Name: Smith, Phyllis Saunders
Phone: (252) 353-7025

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2971 North Carolina

Profile Details

NPI number 1992758429
LBN Legal business name Prosource Therapeutics Llc
DBA Doing business as
Authorized official Smith, Phyllis Saunders
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2006
Last updated Mar 26th, 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 1992758429 NPPES
North Carolina Other 017PN NC BLUE CROSS BLUE SHIELD
North Carolina MEDICAID 6005734 NC BLUE CROSS BLUE SHIELD

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