Organization
MARTIN LIVING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BARBARA ANN RIDGELL (PRESIDENT/CEO)
(910) 658-1254
Entity
Organization
Contact information
Practice address
61 THOMAS DICKENS RD, 61 THOMAS DICKENS ROAD, LILLINGTON, NC 27546-7606
(910) 658-1254
Mailing address
PO BOX 2201, 61 THOMAS DICKENS ROAD, LILLINGTON, NC 27546-2201
(910) 658-1254
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
MHL-043-090
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043-090
—
NC
05
—
120301
—
NC
05
—
MHL043090
—
NC
Enumeration date
05/08/2013
Last updated
09/02/2014
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