Organization
ACTIVE HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ELAINE ELLISON (CONTROLLER)
(919) 870-8600
Entity
Organization
Contact information
Practice address
11709 FRUEHAUF DR, CHARLOTTE, NC 28273-7284
(919) 870-8600
Mailing address
9650 STRICKLAND RD # 103-140, RALEIGH, NC 27615-1902
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7700598
—
NC
Enumeration date
10/05/2017
Last updated
10/05/2017
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