Healthcare Provider Details

I. General information

NPI: 1851093330
Provider Name (Legal Business Name): VERONICA COLEMAN RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 VILLA ST
ROCKY MOUNT NC
27804-5853
US

IV. Provider business mailing address

326 VILLA ST
ROCKY MOUNT NC
27804-5853
US

V. Phone/Fax

Practice location:
  • Phone: 252-469-7325
  • Fax: 877-732-9421
Mailing address:
  • Phone: 252-469-7325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number5924
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: