Provider Demographics
NPI:1376802116
Name:UNIFIED HEALTH CARE SERVICE INC
Entity Type:Organization
Organization Name:UNIFIED HEALTH CARE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BLANGO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-412-0792
Mailing Address - Street 1:1532 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6650
Mailing Address - Country:US
Mailing Address - Phone:252-412-0792
Mailing Address - Fax:
Practice Address - Street 1:3094 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3647
Practice Address - Country:US
Practice Address - Phone:252-412-0792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No252Y00000XAgenciesEarly Intervention Provider Agency