Individual
MRS. TAMMY VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4271 HIGH ST, AYDEN, NC 28513-7107
(252) 746-6388
(252) 746-6388
Mailing address
4271 HIGH ST, AYDEN, NC 28513-7107
(252) 746-6388
(252) 746-6388
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-074-039
NC
343900000X
Non-emergency Medical Transport (VAN)
FCL-074-039
—
Other
Enumeration date
09/06/2012
Last updated
09/06/2012
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