Provider Demographics
NPI:1629476478
Name:HEALTHY LYMPHATICS OF NC PC
Entity Type:Organization
Organization Name:HEALTHY LYMPHATICS OF NC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ALBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-355-9584
Mailing Address - Street 1:450 NEW MARKET BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5494
Mailing Address - Country:US
Mailing Address - Phone:828-355-9584
Mailing Address - Fax:
Practice Address - Street 1:826 22ND STREET PL SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-8321
Practice Address - Country:US
Practice Address - Phone:828-355-9584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-10
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X, 225X00000X, 261QM1300X
NC6615225XP0019X
NC64261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Single Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Single Specialty