Organization
PROFESSIONAL FAMILY HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHALEACCA RESHAUN VAUGHAN (ADMINISTRATOR)
(252) 332-5920
Entity
Organization
Contact information
Practice address
218 CHURCH ST E, AHOSKIE, NC 27910-3518
(252) 332-5920
(252) 332-4460
Mailing address
218 CHURCH ST E, AHOSKIE, NC 27910-3518
(252) 332-5920
(252) 332-4460
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC2949
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3418553
—
NC
Enumeration date
07/02/2009
Last updated
07/02/2009
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