Provider Demographics
NPI:1215647870
Name:JESUS' WORD CHURCH
Entity type:Organization
Organization Name:JESUS' WORD CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF APOSTLE
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:DDIV
Authorized Official - Phone:919-641-1337
Mailing Address - Street 1:1321 HUMPHREY ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-4229
Mailing Address - Country:US
Mailing Address - Phone:919-687-6997
Mailing Address - Fax:919-680-3369
Practice Address - Street 1:1321 HUMPHREY ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4229
Practice Address - Country:US
Practice Address - Phone:919-687-6997
Practice Address - Fax:919-687-6997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF JESUS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)