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Individual

LACEMOND BANKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3904 AIRPORT DR NW, WILSON, NC 27896-8040
(919) 949-5544
Mailing address
PO BOX 2071, WENDELL, NC 27591-2071
(919) 949-5541

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22070
NC
341600000X
Ambulance
3416L0300X
Land Ambulance
343800000X
Secured Medical Transport (VAN)
465435628
NC
343800000X
Secured Medical Transport (VAN)
343900000X
Non-emergency Medical Transport (VAN)
347B00000X
Bus
465435628
NC
347B00000X
Bus
347C00000X
Private Vehicle

Other

Enumeration date
06/24/2015
Last updated
06/27/2023
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