Provider Demographics
NPI:1548941222
Name:DISTINCT CLINICIANS INCORPORATED
Entity type:Organization
Organization Name:DISTINCT CLINICIANS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMAX-MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-986-1959
Mailing Address - Street 1:827 E BROOKLINE ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-3301
Mailing Address - Country:US
Mailing Address - Phone:336-986-1959
Mailing Address - Fax:
Practice Address - Street 1:827 E BROOKLINE ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27107-3301
Practice Address - Country:US
Practice Address - Phone:336-986-1959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health