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General NPI Number Information
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NPI Number | 1306388301
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Entity Type | Organization
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Legal Business Name | HOPE CLINIC
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 203 NORTH ST 2ND FLOOR
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City | BAYBORO
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State | NC
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Zip | 28515-0010
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Country | US
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Telephone | 252-745-5760
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Fax | 252-745-5734
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Provider Business Mailing Address
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Address Line | PO BOX 728
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City | BAYBORO
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State | NC
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Zip | 28515-0728
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Country | US
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Telephone | 252-745-5760
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Fax | 252-745-5734
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SHERI RETTEW
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Credential | MA
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Telephone | 252-745-5760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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