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General NPI Number Information
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NPI Number | 1982480497
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Entity Type | Organization
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Legal Business Name | COLD WAR CITIZENS CARE LLC
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Dates
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Enumeration Date | 08/31/2023
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 1223 AUGUSTA WEST PKWY STE H
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City | AUGUSTA
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State | GA
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Zip | 30909-1807
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Country | US
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Telephone | 800-611-0072
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Fax |
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Provider Business Mailing Address
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Address Line | 658 N SPENCE AVE
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City | GOLDSBORO
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State | NC
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Zip | 27534-4233
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Country | US
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Telephone | 919-223-2411
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACOB SMITH
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Credential |
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Telephone | 919-223-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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