Provider Demographics
NPI:1134278690
Name:DEPENDABLE SERVICES, INC.
Entity type:Organization
Organization Name:DEPENDABLE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:OSTENDORF
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, QDDP
Authorized Official - Phone:252-327-0206
Mailing Address - Street 1:3302 GILEAD SHORES RD
Mailing Address - Street 2:
Mailing Address - City:BLOUNTS CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27814-9795
Mailing Address - Country:US
Mailing Address - Phone:252-975-7466
Mailing Address - Fax:252-975-7466
Practice Address - Street 1:315 CLIFTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5009
Practice Address - Country:US
Practice Address - Phone:252-353-6450
Practice Address - Fax:252-353-6451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300118Medicaid