Healthcare Provider Details

I. General information

NPI: 1578473476
Provider Name (Legal Business Name): PPLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 WESTCHESTER DR
HIGH POINT NC
27262-7008
US

IV. Provider business mailing address

1795 WESTCHESTER DR
HIGH POINT NC
27262-7008
US

V. Phone/Fax

Practice location:
  • Phone: 336-888-4600
  • Fax: 336-888-4645
Mailing address:
  • Phone: 336-888-4600
  • Fax: 336-888-4645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROLYN MCKINNEY
Title or Position: MDS COORDINATOR
Credential: LPN
Phone: 336-888-4600