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Contact Information

SUPPLEMENTAL HEALTHCARE
319 VANCOUVER DRIVE
APARTMENT 38G
FAYETTEVILLE, NC28303
 Phone: 347-447-1868
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for SUPPLEMENTAL HEALTHCARE

NPI Number 1831625037
LBN Legal business name SUPPLEMENTAL HEALTHCARE
Authorized official CHERRELLE HARVIN - (RECRUITING COORDINATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/08/2017
Last updated 05/08/2017 - About 9 years ago
Identifiers
NC Medicaid 1
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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