Organization
MAYO'S LOVING CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL CORMELIUS MAYO SR. (QP)
(252) 281-7717
Entity
Organization
Contact information
Practice address
105 KRISTA LN, ROCKY MOUNT, NC 27803-5228
(252) 973-8593
(252) 407-4950
Mailing address
PO BOX 1705, ROCKY MOUNT, NC 27802-1705
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
MHL 064 115
NC
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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