1952431991 NPI number — BARBARA'S LOVE AND CARE

Table of content: JOHN D. CHULIK M.D. (NPI 1033197488)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952431991 NPI number — BARBARA'S LOVE AND CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARBARA'S LOVE AND CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BARBARA'S LOVING CARE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952431991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 GLENWOOD AVE
Provider Second Line Business Mailing Address:
SUITE 7
Provider Business Mailing Address City Name:
KINSTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28501-3870
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-527-6575
Provider Business Mailing Address Fax Number:
252-527-0200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 GLENWOOD AVE
Provider Second Line Business Practice Location Address:
SUITE 7
Provider Business Practice Location Address City Name:
KINSTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28501-3870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-527-6575
Provider Business Practice Location Address Fax Number:
252-527-0200
Provider Enumeration Date:
03/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SHERROD
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
SMITH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
252-527-6575

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  MHL054077 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: MHL054108 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , with the licence number: MHL054131 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3418195 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7805292 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7804681 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7804922 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7805291 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7804211 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8300891 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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