Provider Demographics
NPI:1093761579
Name:UNITED VISIONS HEALTHCARE
Entity Type:Organization
Organization Name:UNITED VISIONS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:STATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-937-2199
Mailing Address - Street 1:104 ZEBULON CT
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2420
Mailing Address - Country:US
Mailing Address - Phone:252-937-2199
Mailing Address - Fax:252-937-2197
Practice Address - Street 1:104 ZEBULON CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2420
Practice Address - Country:US
Practice Address - Phone:252-937-2199
Practice Address - Fax:252-937-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2928251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408317Medicaid
NC6601261Medicaid