Healthcare Provider Details

I. General information

NPI: 1104753847
Provider Name (Legal Business Name): HJK GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 CENTERVIEW DR
RALEIGH NC
27606-3363
US

IV. Provider business mailing address

PO BOX 2464
SOUTHERN PINES NC
28388-2464
US

V. Phone/Fax

Practice location:
  • Phone: 910-725-4724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: MR. JERMAINE KELLY
Title or Position: CEO
Credential:
Phone: 910-528-5655