Provider Demographics
NPI:1437806924
Name:PICKUS VENTURES
Entity Type:Organization
Organization Name:PICKUS VENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAQED
Authorized Official - Middle Name:N
Authorized Official - Last Name:PICKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-423-1207
Mailing Address - Street 1:39 WILDWOOD GARDENS RD
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-7752
Mailing Address - Country:US
Mailing Address - Phone:828-423-1207
Mailing Address - Fax:
Practice Address - Street 1:1550 HENDERSONVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3199
Practice Address - Country:US
Practice Address - Phone:828-222-0357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care