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General NPI Number Information
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NPI Number | 1871241695
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Entity Type | Organization
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Legal Business Name | CARDINAL CARE OF DUNN
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 217 JONESBORO RD
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City | DUNN
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State | NC
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Zip | 28334-6240
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Country | US
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Telephone | 191-089-2171
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 STALLINGS DR
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City | KINSTON
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State | NC
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Zip | 28504-1444
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Country | US
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Telephone | 125-252-1293
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH CANNON JR.
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Credential |
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Telephone | 252-521-2939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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