Healthcare Provider Details

I. General information

NPI: 1477280378
Provider Name (Legal Business Name): GERALD ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 SASSACUS LN
APEX NC
27523-3836
US

IV. Provider business mailing address

2007 SASSACUS LN
APEX NC
27523-3836
US

V. Phone/Fax

Practice location:
  • Phone: 919-267-9711
  • Fax:
Mailing address:
  • Phone: 919-267-9711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHC6974
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: