Provider Demographics
NPI:1649585837
Name:SYMAKLA WATSON INVESTMENTS CORPORATION
Entity Type:Organization
Organization Name:SYMAKLA WATSON INVESTMENTS CORPORATION
Other - Org Name:S A MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LASONYA
Authorized Official - Middle Name:SCHMEACE
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, PHA
Authorized Official - Phone:704-947-8383
Mailing Address - Street 1:9700 RESEARCH DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8552
Mailing Address - Country:US
Mailing Address - Phone:704-405-4687
Mailing Address - Fax:704-947-8385
Practice Address - Street 1:9700 RESEARCH DR
Practice Address - Street 2:SUITE 109
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8552
Practice Address - Country:US
Practice Address - Phone:704-405-4687
Practice Address - Fax:704-947-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3420251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC3420Medicaid
NC6601527Medicaid