Provider Demographics
NPI:1306388301
Name:HOPE CLINIC
Entity Type:Organization
Organization Name:HOPE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:RETTEW
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:252-745-5760
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:
Mailing Address - City:BAYBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28515-0728
Mailing Address - Country:US
Mailing Address - Phone:252-745-5760
Mailing Address - Fax:252-745-5734
Practice Address - Street 1:203 NORTH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAYBORO
Practice Address - State:NC
Practice Address - Zip Code:28515-0010
Practice Address - Country:US
Practice Address - Phone:252-745-5760
Practice Address - Fax:252-745-5734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service