Provider Demographics
NPI:1619624590
Name:AVL HEALTHCARE SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:AVL HEALTHCARE SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUENTON
Authorized Official - Middle Name:T
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:704-965-3795
Mailing Address - Street 1:2116 PITAL CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28214-8118
Mailing Address - Country:US
Mailing Address - Phone:704-965-3795
Mailing Address - Fax:
Practice Address - Street 1:2116 PITAL CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28214-8118
Practice Address - Country:US
Practice Address - Phone:704-965-3795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental ModificationGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4OtherHUMANA
NC5OtherMEDCOST
NC2OtherUNITED HEALTHCARE
NC1OtherBLUE CROSS BLUE SHIELD
NC3OtherAETNA INSURANCE