Provider Demographics
NPI:1033406186
Name:SURRENT CAPITAL, INC
Entity Type:Organization
Organization Name:SURRENT CAPITAL, INC
Other - Org Name:COBB'S HOME CARE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YUSSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:GILKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-602-2940
Mailing Address - Street 1:3540 VEST MILL RD STE 6
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2988
Mailing Address - Country:US
Mailing Address - Phone:336-602-2940
Mailing Address - Fax:336-245-8133
Practice Address - Street 1:3020 PICKETT RD STE 6
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6000
Practice Address - Country:US
Practice Address - Phone:336-602-2940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4329251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health