Provider Demographics
NPI:1417036617
Name:SOPHIA B PIERCE AND ASSOCIATES INC
Entity Type:Organization
Organization Name:SOPHIA B PIERCE AND ASSOCIATES INC
Other - Org Name:SUNNY ACRES GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:BLANKS
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:910-488-8477
Mailing Address - Street 1:PO BOX 2813
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28302
Mailing Address - Country:US
Mailing Address - Phone:910-482-3182
Mailing Address - Fax:910-822-1951
Practice Address - Street 1:904 SOUTHVIEW CIRCLE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28311
Practice Address - Country:US
Practice Address - Phone:910-482-3182
Practice Address - Fax:910-822-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7804355Medicaid