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General NPI Number Information
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NPI Number | 1124208640
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Entity Type | Organization
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Legal Business Name | COOK AND GEORGE INC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 305 HARRISON AVE
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City | YADKINVILLE
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State | NC
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Zip | 27055-8247
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Country | US
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Telephone | 336-679-2386
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Fax | 336-679-4510
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Provider Business Mailing Address
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Address Line | 6010 MEADOWBROOK MALL CT
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City | CLEMMONS
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State | NC
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Zip | 27012-9266
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Country | US
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Telephone | 336-766-8050
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Fax | 336-766-8054
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Authorized Official
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Title or Position | OWNER
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Name | PAUL COOK
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Credential |
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Telephone | 336-682-9334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | HAL099012
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License Number State | NC
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