Organization
OASIS HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRINA ANTOINETTE FONVILLE (DIRECTOR)
(704) 213-6225
Entity
Organization
Contact information
Practice address
1101 TYVOLA RD, CHARLOTTE, NC 28217-3515
(704) 213-6225
(704) 216-1406
Mailing address
1101 TYVOLA RD STE 301, CHARLOTTE, NC 28217-3515
(704) 213-6225
(704) 216-1406
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC4362
NC
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285016824
—
NC
Enumeration date
06/19/2015
Last updated
03/17/2018
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