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General NPI Number Information
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NPI Number | 1689060873
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Entity Type | Organization
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Legal Business Name | NORTH BREVARD CHARITIES SHARING CENTER, INC.
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 4475 S HOPKINS AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-6661
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Country | US
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Telephone | 321-269-6555
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Fax | 321-268-5347
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Provider Business Mailing Address
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Address Line | 4475 S HOPKINS AVE
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City | TITUSVILLE
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State | FL
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Zip | 32780-6661
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Country | US
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Telephone | 321-269-6555
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Fax | 321-268-5347
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Authorized Official
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Title or Position | CEO, EXECUTIVE DIRECTOR
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Name | MR. JOE C ROBINSON
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Credential |
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Telephone | 321-383-3026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 858012589712C2
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License Number State | FL
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