Healthcare Provider Details

I. General information

NPI: 1821863432
Provider Name (Legal Business Name): MIRACLES BLESSINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2023
Last Update Date: 11/24/2023
Certification Date: 11/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 BLYTHE RD # A
GARYSBURG NC
27831-9568
US

IV. Provider business mailing address

215 BLYTHE RD # A
GARYSBURG NC
27831-9568
US

V. Phone/Fax

Practice location:
  • Phone: 252-678-2602
  • Fax: 252-541-2811
Mailing address:
  • Phone: 252-678-2602
  • Fax: 252-541-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JERONDA LACHELLE ARTIS
Title or Position: CEO
Credential:
Phone: 252-678-2602