Provider Demographics
NPI:1922478692
Name:PERKINS, VALENTINE LONG
Entity Type:Individual
Prefix:
First Name:VALENTINE
Middle Name:LONG
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 SPRINGHILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8516
Mailing Address - Country:US
Mailing Address - Phone:252-347-3258
Mailing Address - Fax:
Practice Address - Street 1:2366 SPRINGHILL RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-8516
Practice Address - Country:US
Practice Address - Phone:252-347-3258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06-00016623SC343900000X
NC14-00017589344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)