Provider Demographics
NPI:1033499801
Name:ACON HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:ACON HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:OGUGUA
Authorized Official - Last Name:ANACHUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-961-0248
Mailing Address - Street 1:4505 COBBLE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-0702
Mailing Address - Country:US
Mailing Address - Phone:919-961-0248
Mailing Address - Fax:919-341-2929
Practice Address - Street 1:4909 WATERS EDGE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2462
Practice Address - Country:US
Practice Address - Phone:919-961-0248
Practice Address - Fax:919-341-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4326253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care