Provider Demographics
NPI:1942660352
Name:FIVE POINTS HEALTHCARE OF NC, LLC
Entity Type:Organization
Organization Name:FIVE POINTS HEALTHCARE OF NC, LLC
Other - Org Name:FIVE POINTS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:RADICS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-692-4417
Mailing Address - Street 1:1540 PURDUE DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5509
Mailing Address - Country:US
Mailing Address - Phone:910-323-3628
Mailing Address - Fax:910-323-3628
Practice Address - Street 1:1540 PURDUE DR
Practice Address - Street 2:SUITE 302
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5509
Practice Address - Country:US
Practice Address - Phone:910-323-3628
Practice Address - Fax:910-323-3628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3421251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health