1053458588 NPI number — UNIFIED COMMUNITY HUMAN SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053458588 NPI number — UNIFIED COMMUNITY HUMAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIFIED COMMUNITY HUMAN SERVICES
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:
1053458588
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6587
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKY MOUNT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27802-6587
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-985-2007
Provider Business Mailing Address Fax Number:
252-985-2004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 NASH ST N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILSON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27896-1394
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-293-0003
Provider Business Practice Location Address Fax Number:
252-206-0004
Provider Enumeration Date:
02/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
LINWOOD
Authorized Official Middle Name:
JOLLIE
Authorized Official Title or Position:
PRESIDENTCEO
Authorized Official Telephone Number:
252-985-2007

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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