Provider Demographics
NPI:1104698166
Name:HAMMONDS, JOHNATHON
Entity type:Individual
Prefix:
First Name:JOHNATHON
Middle Name:
Last Name:HAMMONDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-5526
Mailing Address - Country:US
Mailing Address - Phone:910-992-4556
Mailing Address - Fax:
Practice Address - Street 1:325 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5526
Practice Address - Country:US
Practice Address - Phone:910-992-4556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC7181251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health