PROSOURCE THERAPEUTICS LLC NPI 1720225014

NPI Information

  • NPI: 1720225014
  • Provider Name: PROSOURCE THERAPEUTICS, LLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 201 E PITT ST
    TARBORO, NC
    ZIP 27886
  • Phone: (252) 353-7025

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NPI Details

PROSOURCE THERAPEUTICS, LLC is a professional counselor in Tarboro, NC. PROSOURCE THERAPEUTICS, LLC NPI is 1720225014. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

201 E PITT ST
TARBORO, NC
ZIP 27886-192
Phone: (252) 353-7025

The provider's authorized official is Felicia Smith .
The authorized official title is Administrator and has the following contact phone number (252) 353-7025.

The enumeration date for this NPI number is 1/8/2009 and was last updated on 1/8/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1017PNOTHERNORTH CAROLINANC BLUE CROSS BLUE SHIELD
26005734MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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