1558643551 NPI number — ALZHEIMER'S RELATED CARE OF DUNN, LLC

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 1558643551 NPI number — ALZHEIMER'S RELATED CARE OF DUNN, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALZHEIMER'S RELATED CARE OF DUNN, 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:
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:
1558643551
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/15/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 923
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DUNN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28335-0923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-892-1711
Provider Business Mailing Address Fax Number:
910-892-5343

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 JONESBORO RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-892-1711
Provider Business Practice Location Address Fax Number:
910-892-5343
Provider Enumeration Date:
09/15/2011

Additional Information

Authorized Official

Authorized Official Last Name:
JACOBS
Authorized Official First Name:
CINDY
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
910-425-6966

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  HAL-043-026 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com