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General NPI Number Information
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NPI Number | 1467650036
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Entity Type | Organization
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Legal Business Name | PITTMAN FAMILY CARE
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 47 PINEY HAVEN DR
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City | BAKERSVILLE
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State | NC
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Zip | 28705-0525
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Country | US
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Telephone | 828-688-3971
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Fax | 828-688-3971
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Provider Business Mailing Address
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Address Line | 47 PINEY HAVEN DR
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City | BAKERSVILLE
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State | NC
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Zip | 28705-0525
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Country | US
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Telephone | 828-688-3971
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Fax | 828-688-3971
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Authorized Official
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Title or Position | OWNER
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Name | MR. BOBBY GENE PITTMAN
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Credential |
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Telephone | 828-688-3971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number | FCL-061-003
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License Number State | NC
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