Provider Demographics
NPI:1285218933
Name:DR. ROBIN PEACE LLC
Entity Type:Organization
Organization Name:DR. ROBIN PEACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:YOLANDA
Authorized Official - Last Name:PEACE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-734-6247
Mailing Address - Street 1:1105 LAUREL OAK LN
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2183
Mailing Address - Country:US
Mailing Address - Phone:910-734-6247
Mailing Address - Fax:
Practice Address - Street 1:1150 PINE RUN DR
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2118
Practice Address - Country:US
Practice Address - Phone:910-734-6247
Practice Address - Fax:754-212-0473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Multi-Specialty