Healthcare Provider Details

I. General information

NPI: 1215891692
Provider Name (Legal Business Name): ETERNAL HOPE THERAPEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 ALBEMARLE RD
ASHEBORO NC
27203-6259
US

IV. Provider business mailing address

1383 WALKER RD
ASHEBORO NC
27205-2225
US

V. Phone/Fax

Practice location:
  • Phone: 336-953-7049
  • Fax:
Mailing address:
  • Phone: 336-953-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER VUNCANNON
Title or Position: OWNER
Credential:
Phone: 336-953-7004