Healthcare Provider Details

I. General information

NPI: 1033153606
Provider Name (Legal Business Name): JOHNSTON HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 HOSPITAL RD
SMITHFIELD NC
27577
US

IV. Provider business mailing address

PO BOX 1376
SMITHFIELD NC
27577-1376
US

V. Phone/Fax

Practice location:
  • Phone: 919-209-5100
  • Fax: 919-209-5150
Mailing address:
  • Phone: 919-209-5100
  • Fax: 919-209-5150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHC0383
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberHC0383
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberH054088
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberHOS4088
License Number StateNC

VIII. Authorized Official

Name: MR. KEVIN MICHAEL CIELINSKI
Title or Position: CFO
Credential:
Phone: 919-938-7128