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NPI Code Detail

MEDICARE: LOUAL, LLC

MEDICARE: LOUAL, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1311500000XAlzheimer Center (Dementia Center)
2310400000XAssisted Living Facility

General Provider Information

NPI Number : 1922297597
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOUAL, LLC
Provider Business Mailing Address
First Line : PO BOX 1487
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27285-1487
Country : US
Telephone Number : 336-595-1075
Fax Number : 336-595-1078
Provider Business Practice Location Address
First Line : 3407 OAKS RD
Second Line :
City : NEW BERN
State : NC
Zip : 28560-2718
Country : US
Telephone Number : 252-633-1143
Fax Number : 252-633-0422
Authorized Official
Title or Position : MEMBER
Name : AL STEPHEN PIERCE
Credential :
Telephone Number : 336-595-1075
Provider Enumeration Date : 10/19/2007
Last Update Date : 10/19/2007

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Directions to “LOUAL, LLC ” Practice Location

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