Healthcare Provider Details

I. General information

NPI: 1437400918
Provider Name (Legal Business Name): PEACEKEEPERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 09/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 HOPKINS RD
MIDDLESEX NC
27557
US

IV. Provider business mailing address

5430 HOPKINS RD
MIDDLESEX NC
27557
US

V. Phone/Fax

Practice location:
  • Phone: 919-593-2527
  • Fax: 919-300-1596
Mailing address:
  • Phone: 919-593-2527
  • Fax: 919-300-1596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC4043
License Number StateNC

VIII. Authorized Official

Name: WINDOLYN AJ TURNER
Title or Position: AGENT
Credential: CNA
Phone: 919-593-2527