Provider Demographics
NPI:1629600770
Name:KORU SERVICES LLC
Entity Type:Organization
Organization Name:KORU SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TENISHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAZEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-215-7679
Mailing Address - Street 1:412 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2454
Mailing Address - Country:US
Mailing Address - Phone:252-215-7679
Mailing Address - Fax:
Practice Address - Street 1:412 WARREN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2454
Practice Address - Country:US
Practice Address - Phone:252-215-7679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness