Provider Demographics
NPI:1871241695
Name:CARDINAL CARE OF DUNN
Entity Type:Organization
Organization Name:CARDINAL CARE OF DUNN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-521-2939
Mailing Address - Street 1:2100 STALLINGS DR
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-1444
Mailing Address - Country:US
Mailing Address - Phone:125-252-1293
Mailing Address - Fax:
Practice Address - Street 1:217 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-6240
Practice Address - Country:US
Practice Address - Phone:191-089-2171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)