Provider Demographics
NPI:1548999212
Name:BEGULIA, CHARLES VINCENT JR (CNA,CMA)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:VINCENT
Last Name:BEGULIA
Suffix:JR
Gender:M
Credentials:CNA,CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-2260
Mailing Address - Country:US
Mailing Address - Phone:620-644-2438
Mailing Address - Fax:
Practice Address - Street 1:623 W 4TH ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-2260
Practice Address - Country:US
Practice Address - Phone:620-644-2438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty