Provider Demographics
NPI:1083471312
Name:PATIENT EMPOWERMENT SERVICES AGENCY
Entity Type:Organization
Organization Name:PATIENT EMPOWERMENT SERVICES AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AVIS
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-300-0251
Mailing Address - Street 1:3117 WHITING AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-1648
Mailing Address - Country:US
Mailing Address - Phone:980-300-0251
Mailing Address - Fax:
Practice Address - Street 1:3117 WHITING AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-1648
Practice Address - Country:US
Practice Address - Phone:980-300-0251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health