Provider Demographics
NPI:1437323763
Name:MCCULLERS, VALARIE C (CEO)
Entity Type:Individual
Prefix:MS
First Name:VALARIE
Middle Name:C
Last Name:MCCULLERS
Suffix:
Gender:F
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-0452
Mailing Address - Country:US
Mailing Address - Phone:919-963-9167
Mailing Address - Fax:919-963-9168
Practice Address - Street 1:10590 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8187
Practice Address - Country:US
Practice Address - Phone:919-963-9167
Practice Address - Fax:919-963-9168
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant