1023922556 NPI number — NEW NAME BORN LLC

Table of content: (NPI 1023922556)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023922556 NPI number — NEW NAME BORN LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW NAME BORN LLC
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:
Provider Other Organization Name Type Code:
6
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:
1023922556
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
232 E FRANKLIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKINGHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28379-3627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
472-248-0914
Provider Business Mailing Address Fax Number:
472-279-1220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
232 E FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKINGHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28379-3627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
472-248-0914
Provider Business Practice Location Address Fax Number:
472-279-1220
Provider Enumeration Date:
10/01/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NWAFOR
Authorized Official First Name:
CYPRIEL
Authorized Official Middle Name:
FIDELIS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
704-777-5710

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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