Healthcare Provider Details

I. General information

NPI: 1720429392
Provider Name (Legal Business Name): CMS AGENCY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2013
Last Update Date: 07/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 W ARMFIELD ST
SAINT PAULS NC
28384-1526
US

IV. Provider business mailing address

408 W ARMFIELD ST
SAINT PAULS NC
28384-1526
US

V. Phone/Fax

Practice location:
  • Phone: 910-865-9299
  • Fax: 910-865-9298
Mailing address:
  • Phone: 910-865-9299
  • Fax: 910-865-9298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMMY SUE SEGURA
Title or Position: PRESIDENT
Credential: B.S.
Phone: 910-865-9299