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Organization

A PRIMARY CHOICE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THAD J DAVIS (CEO)
(910) 865-3500
Entity
Organization

Contact information

Practice address
302 NORTH MAIN STREET SUITE 2, KENANSVILLE, NC 28349-9044
(910) 865-3500
Mailing address
PO BOX 159, SAINT PAULS, NC 28384-0159
(910) 865-3500

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
HC3430
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6601713
NC
Enumeration date
10/18/2006
Last updated
09/28/2017
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