Healthcare Provider Details

I. General information

NPI: 1356279947
Provider Name (Legal Business Name): A GREATER STORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W JACKSON ST
RICH SQUARE NC
27869-9747
US

IV. Provider business mailing address

PO BOX 25
RICH SQUARE NC
27869-0025
US

V. Phone/Fax

Practice location:
  • Phone: 252-287-1660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: TIARA DUKES
Title or Position: INCORPORATOR
Credential: PHARMD
Phone: 252-287-1660