Healthcare Provider Details

I. General information

NPI: 1346613387
Provider Name (Legal Business Name): BUSINESS OPPORTUNITIES FOR SELF SUFFICERNCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 HUNTING BOW DRIVE
HOPE MILLS NC
28307-1320
US

IV. Provider business mailing address

PO BOX 71320
FORT BRAGG NC
28307-1320
US

V. Phone/Fax

Practice location:
  • Phone: 253-376-6503
  • Fax:
Mailing address:
  • Phone: 253-376-6503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number1422118
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1422118
License Number StateNC

VIII. Authorized Official

Name: MS. JERETHA MARBURY
Title or Position: CEO
Credential:
Phone: 253-376-6503