Organization
PROSOURCE THERAPEUTICS LLC
Active
Organization
PROSOURCE THERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLLIS SAUNDERS SMITH (ADMINISTRATOR)
(252) 353-7025
Entity
Organization
Contact information
Practice address
102 FOX HAVEN DR, SUITE A, GREENVILLE, NC 27858-7100
(252) 353-7025
(252) 353-7028
Mailing address
102 FOX HAVEN DR, SUITE A, GREENVILLE, NC 27858-7100
(252) 353-7025
(252) 353-7028
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2971
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017PN
NC BLUE CROSS BLUE SHIELD
NC
05
—
6005734
—
NC
Enumeration date
05/18/2006
Last updated
03/26/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up