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General NPI Number Information
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NPI Number | 1568772044
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Entity Type | Organization
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Legal Business Name | GODS LITTLE WOMEN INC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 201 B KRISTIN DR
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City | GREENVILLE
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State | NC
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Zip | 27834
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Country | US
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Telephone | 252-320-2287
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31177
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City | GREENVILLE
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State | NC
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Zip | 27833
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Country | US
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Telephone | 252-320-2287
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SANDRA L BARRETT
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Credential |
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Telephone | 252-320-2287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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