Provider Demographics
NPI:1619210531
Name:PJH PCS SERVICES
Entity Type:Organization
Organization Name:PJH PCS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIGHT
Authorized Official - Middle Name:
Authorized Official - Last Name:WINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-730-3756
Mailing Address - Street 1:2 DAVIS DR
Mailing Address - Street 2:SUITE 113A
Mailing Address - City:RTP
Mailing Address - State:NC
Mailing Address - Zip Code:27709-0003
Mailing Address - Country:US
Mailing Address - Phone:919-730-3756
Mailing Address - Fax:919-361-1891
Practice Address - Street 1:2 DAVIS DR
Practice Address - Street 2:SUITE 113A
Practice Address - City:RTP
Practice Address - State:NC
Practice Address - Zip Code:27709-0003
Practice Address - Country:US
Practice Address - Phone:919-730-3756
Practice Address - Fax:919-361-1891
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEACE AND JOY HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC 3767251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6602407Medicaid