Provider Demographics
NPI:1467825943
Name:FIDELITY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:FIDELITY HEALTHCARE SERVICES
Other - Org Name:FIDELITY HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:OSITA
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-201-8914
Mailing Address - Street 1:2327 ENGLERT DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4446
Mailing Address - Country:US
Mailing Address - Phone:919-806-0009
Mailing Address - Fax:919-806-1201
Practice Address - Street 1:2327 ENGLERT DR
Practice Address - Street 2:SUITE 306
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4446
Practice Address - Country:US
Practice Address - Phone:919-806-0009
Practice Address - Fax:919-806-1201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIDELITY COMMUNITY SUPPORT GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4098251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health