Organization
PRODIGY HEALTHCARE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELECHI C UWAKWE R.N. (PRESIDENT/CEO)
(919) 264-9769
Entity
Organization
Contact information
Practice address
4801 HARGROVE ROAD, SUITE 12, RALEIGH, NC 27616-1949
(919) 264-9769
(919) 341-5838
Mailing address
4801 HARGROVE ROAD, SUITE 12, RALEIGH, NC 27616-1949
(919) 264-9769
(919) 341-5838
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704536
—
NC
Enumeration date
05/28/2006
Last updated
07/01/2009
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