1326122086 NPI number — PLEMMONS ENTERPRISES

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 1326122086 NPI number — PLEMMONS ENTERPRISES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLEMMONS ENTERPRISES
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:
1326122086
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1025 LAMB RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27295-5229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-853-7670
Provider Business Mailing Address Fax Number:
336-853-7671

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
592 HILLTOP DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINWOOD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27299-9136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-853-8113
Provider Business Practice Location Address Fax Number:
336-853-8105
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LOFLIN
Authorized Official First Name:
TISHA
Authorized Official Middle Name:
TUTTLE
Authorized Official Title or Position:
CO-ADMINISTRATOR
Authorized Official Telephone Number:
336-853-7670

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7801155 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com