Organization
BJ PROFESSIONAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARVIS CARL LOCKHART (ADMINISTRATOR)
(910) 862-2484
Entity
Organization
Contact information
Practice address
1206 TWISTED HICKORY RD, ELIZABETHTOWN, NC 28337-5216
(910) 862-2484
(910) 862-6121
Mailing address
1206 TWISTED HICKORY RD, ELIZABETHTOWN, NC 28337-5216
(910) 862-2484
(910) 862-6121
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
167712
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100292
—
NC
Enumeration date
06/27/2007
Last updated
08/22/2020
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