Organization
THE FULL COVERAGE PDN COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERMAN RUSSELL PIPPIN (ADMINISTRATOR)
(919) 803-4000
Entity
Organization
Contact information
Practice address
8396 SIX FORKS RD, SUITE 102, RALEIGH, NC 27615-3058
(919) 803-4000
(888) 248-7987
Mailing address
8396 SIX FORKS RD, SUITE 102, RALEIGH, NC 27615-3058
(919) 803-4000
(888) 248-7987
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
HC4714
NC
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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