Provider Demographics
NPI:1164969515
Name:SYNERGY HEALTHCARE USA, LLC
Entity Type:Organization
Organization Name:SYNERGY HEALTHCARE USA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWICEGOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-505-8406
Mailing Address - Street 1:PO BOX 1069
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-1069
Mailing Address - Country:US
Mailing Address - Phone:980-505-8406
Mailing Address - Fax:704-966-0056
Practice Address - Street 1:3140 N HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-7314
Practice Address - Country:US
Practice Address - Phone:980-505-8406
Practice Address - Fax:704-966-0056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty