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Organization

TRISOUTH HEALTH SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VERONICA SOUTHERLAND RN, BSW (ADMINISTRATOR)
(704) 493-3422
Entity
Organization

Contact information

Practice address
756 TYVOLA RD, SUITE 143, CHARLOTTE, NC 28217-3588
(704) 493-3422
Mailing address
PO BOX 242036, CHARLOTTE, NC 28224-2036
(704) 493-3422

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6601586
NC
Enumeration date
12/31/2007
Last updated
12/31/2007
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