Basic Information
| Provider Information | |||||||||
| NPI: | 1487921763 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACCOUNTABILITY HEALTHCARE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7756 | ||||||||
| Address2: | |||||||||
| City: | ROCKY MOUNT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278040756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2629851371 | ||||||||
| FaxNumber: | 2524672339 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 PROFESSIONAL PARK DR | ||||||||
| Address2: | |||||||||
| City: | CLARKSVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370405244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2529851371 | ||||||||
| FaxNumber: | 2524672339 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2011 | ||||||||
| LastUpdateDate: | 11/30/2011 | ||||||||
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| AuthorizedOfficialLastName: | HOLLIS | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2529851371 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.