Prosource Therapeutics, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PROSOURCE THERAPEUTICS, LLC

Practice address

622 East Blvd
Williamston, NC 27892-2736

Phone

(252) 353-7025

NPI assigned

Jun 25, 2008

Last updated

Jun 25, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Phyllis Smith

Title

Owner

Phone

(252) 353-7025

Specialties & licenses 1

Addresses

Tax ID family

Prosource Therapeutics LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Prosource Therapeutics

  • Clinical Social Worker
  • New Bern, NC
  • NPI 1659530145
  NPD tax ID
• Prosource Therapeutics, LLC

  • Clinical Social Worker
  • Robersonville, NC
  • NPI 1578799664
  NPD tax ID
• Prosource Therapeutics, LLC

  • Professional Counselor
  • Tarboro, NC
  • NPI 1720225014
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1811158546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 FOX HAVEN DR",
            "address_2": "SUITE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278589720",
            "telephone_number": "252-353-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 EAST BLVD",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922736",
            "telephone_number": "252-353-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSOURCE THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-353-7025"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Sadler Planck, FNP-C
• Positive Community Connections
• Edward Delane Price, D.D.S.
• Sarah Long Price, RN
• Pro-Med Equipment and Supply, Inc
• Providence Rehabilitation and Hospice Services
• Shana B Putnam, CRT, RCP
• QFM Enterprise LLC
• R and R Elite Enterprises LLC
• R.E.a.L.I.T.Y. Counseling and Consulting, LLC

• Clinical Social Worker in Williamston, NC
• Providers in Williamston, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.