Organization
RAINBOW 66 STOREHOUSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMMIE C. JOHNSON (PRESIDENT)
(910) 276-0766
Entity
Organization
Contact information
Practice address
525 ATKINSON ST, LAURINBURG, NC 28352-3715
(910) 276-0766
(910) 277-6295
Mailing address
525 ATKINSON ST, LAURINBURG, NC 28352-3715
(910) 276-0766
(910) 277-6295
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC 2475
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409455
—
NC
05
—
3418378
—
NC
05
—
6601037
—
NC
05
—
7804558
—
NC
05
—
8302212
—
NC
Enumeration date
10/20/2006
Last updated
03/31/2015
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