CRYSTAL HEALTH CARE SERVICES, INC NPI 1003032947

Nursing Care in Charlotte, NC

NPI 1003032947 Organization Nursing Care

About CRYSTAL HEALTH CARE SERVICES, INC

Crystal Health Care Services, Inc is a provider established in Charlotte, North Carolina specializing in nursing care. The NPI number of Crystal Health Care Services, Inc is 1003032947 and was assigned on April 2007. The practitioner's primary taxonomy code is 251J00000X with license number HC3464 (NC). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Ms. Kathryn Theresa White (Administrator)

NPI

1003032947

Provider NameCRYSTAL HEALTH CARE SERVICES, INC
Provider Location Address1300 BAXTER STREET SUITE 190 CHARLOTTE, NC 28204
Provider Mailing Address1300 BAXTER STREET SUITE 190 CHARLOTTE, NC 28204
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-18-2007
Last Update Date08-05-2009


Primary Taxonomy

Taxonomy Code251J00000X
ClassificationNursing Care
TypeAgencies
License No.HC3464
License StateNC
Taxonomy DescriptionA Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.

Business Address

CRYSTAL HEALTH CARE SERVICES, INC
1300 BAXTER STREET
SUITE 190
CHARLOTTE, NC
ZIP 28204
Phone: (704) 334-2311
Fax: (704) 334-2310

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Mailing Address

CRYSTAL HEALTH CARE SERVICES, INC
1300 BAXTER STREET
SUITE 190
CHARLOTTE, NC
ZIP 28204
Phone: (704) 334-2311
Fax: (704) 334-2310



Authorized Official

Authorized Official NameMS. KATHRYN THERESA WHITE
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(704) 334-2311

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
3412841MEDICAID (05)NC

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1376637033CRYSTAL HEALTH CARE SERVICES, INC
Organization
Nursing Care1300 BAXTER STREET SUITE 190
CHARLOTTE, NC 28204
(704) 334-2311
1548486491CRYSTAL HEALTH CARE SERVICES INC
Organization
Nursing Care1300 BAXTER STREET SUITE 190
CHARLOTTE, NC 28204
(704) 334-2311

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.