Healthcare Provider Details

I. General information

NPI: 1699847541
Provider Name (Legal Business Name): SOPHIA B PIERCE & ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 COUNTRY CLUB DRIVE
FAYETTEVILLE NC
28301
US

IV. Provider business mailing address

PO BOX 2813
FAYETTEVILLE NC
28302
US

V. Phone/Fax

Practice location:
  • Phone: 910-630-6818
  • Fax: 910-822-1951
Mailing address:
  • Phone: 910-630-6818
  • Fax: 910-822-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. SOPHIA BLANKS PIERCE
Title or Position: EXECUTIVE DIRECTOR
Credential: EDD
Phone: 910-488-8477