Provider Demographics
NPI:1487778916
Name:SOS,INC
Entity type:Organization
Organization Name:SOS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEREE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-330-2188
Mailing Address - Street 1:2 DEWITT ST # 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-5649
Mailing Address - Country:US
Mailing Address - Phone:910-347-2001
Mailing Address - Fax:910-324-2725
Practice Address - Street 1:2 DEWITT ST # 6
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5649
Practice Address - Country:US
Practice Address - Phone:910-347-3001
Practice Address - Fax:910-324-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418355Medicaid