Provider Demographics
NPI:1386748721
Name:KAMMER ENTERPRISES, INC
Entity type:Organization
Organization Name:KAMMER ENTERPRISES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-542-2520
Mailing Address - Street 1:PO BOX 1279
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-1279
Mailing Address - Country:US
Mailing Address - Phone:919-524-2520
Mailing Address - Fax:919-545-5540
Practice Address - Street 1:290 EAST ST.
Practice Address - Street 2:SUITE102
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9730
Practice Address - Country:US
Practice Address - Phone:919-542-2520
Practice Address - Fax:919-545-5540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3443251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601540Medicaid