Provider Demographics
NPI:1609843143
Name:SENTRIC, INC.
Entity Type:Organization
Organization Name:SENTRIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-832-9555
Mailing Address - Street 1:6100 MADDRY OAKS CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-3156
Mailing Address - Country:US
Mailing Address - Phone:919-832-9555
Mailing Address - Fax:919-256-1801
Practice Address - Street 1:6100 MADDRY OAKS CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-3156
Practice Address - Country:US
Practice Address - Phone:919-832-9555
Practice Address - Fax:919-256-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00580332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703835Medicaid
NC045N0OtherBCBS
NC9433392948OtherTRICARE
NC7703835Medicaid