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Contact Information

SENIOR HEALTH CONNECTION
7903 PROVIDENCE RD
SUITE 100
CHARLOTTE, NC28277-9720
 Phone: 704-543-4360
 Fax: 704-544-2385
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for SENIOR HEALTH CONNECTION

NPI # 1578597555
LBN Legal business name SENIOR HEALTH CONNECTION
Authorized official DANIEL WIENS - (SENIOR VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/10/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
NC Medicaid 89011E1
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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