| Prodigious Health Services, Llc | |
|
210 N Main St Roxboro NC 27573-5325 | |
| (252) 433-0300 | |
| (252) 433-8054 |
| Full Name | Prodigious Health Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 210 N Main St, Roxboro, North Carolina |
| Authorized Official Name and Position | Bobby Faison (PRESIDENT) |
| Authorized Official Contact | 2524330300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodigious Health Services, Llc Po Box 2120 Henderson NC 27536-2120 Ph: (252) 433-0300 | Prodigious Health Services, Llc 210 N Main St Roxboro NC 27573-5325 Ph: (252) 433-0300 |
| NPI Number | 1720389182 |
|---|---|
| Provider Enumeration Date | 11/16/2010 |
| Last Update Date | 11/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720389182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 875 (North Carolina) | Primary |
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