Provider Demographics
NPI:1174853493
Name:PBM HEALTH SERVICES CONSULTING
Entity type:Organization
Organization Name:PBM HEALTH SERVICES CONSULTING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:V
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, CCM, MBA
Authorized Official - Phone:919-225-5037
Mailing Address - Street 1:4819 EMPEROR BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5420
Mailing Address - Country:US
Mailing Address - Phone:919-313-4816
Mailing Address - Fax:919-313-4819
Practice Address - Street 1:4819 EMPEROR BLVD
Practice Address - Street 2:STE 400
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5420
Practice Address - Country:US
Practice Address - Phone:919-313-4816
Practice Address - Fax:919-313-4819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251J00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care