Provider Demographics
NPI:1700543162
Name:NC DEPT OF MILITARY AND VETERANS AFFAIRS
Entity type:Organization
Organization Name:NC DEPT OF MILITARY AND VETERANS AFFAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DEPUTY SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:984-204-8333
Mailing Address - Street 1:4001 MAIL SERVICE CTR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27699
Mailing Address - Country:US
Mailing Address - Phone:984-204-2982
Mailing Address - Fax:984-204-8343
Practice Address - Street 1:1795 KERNERSVILLE MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284
Practice Address - Country:US
Practice Address - Phone:743-209-3042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility