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General NPI Number Information
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NPI Number | 1518084680
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Entity Type | Organization
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Legal Business Name | BAR ENTERPRISES OF PERQUIMANS INC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 117 GREGORYS LN
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City | HERTFORD
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State | NC
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Zip | 27944-8878
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Country | US
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Telephone | 252-264-2055
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Fax |
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Provider Business Mailing Address
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Address Line | 117 GREGORYS LN
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City | HERTFORD
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State | NC
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Zip | 27944-8878
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Country | US
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Telephone | 252-264-2055
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATER
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Name | MRS. ANNETTE RUSSELL LUTHER
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Credential |
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Telephone | 252-264-2055
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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 | 7801482
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License Number State | NC
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