Pioneer Health Services of Stokes County, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

H1065 Issued in NC

Legal business name

PIONEER HEALTH SERVICES OF STOKES COUNTY, INC.

Practice address

1072 N Main St
Walnut Cove, NC 27052-9312

Phone

(336) 591-7001

Fax

(336) 591-7007

NPI assigned

Jun 11, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Joseph S. McNulty III

Title

Ceo

Phone

(601) 849-6440

Specialties & licenses 1

Addresses

Other names 1

• Pioneer Family Medical of Walnut Cove Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1134481674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PIONEER WAY",
            "city": "MAGEE",
            "state": "MS",
            "postal_code": "391115501",
            "telephone_number": "601-849-6440",
            "fax_number": "601-849-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 N MAIN ST",
            "city": "WALNUT COVE",
            "state": "NC",
            "postal_code": "270529312",
            "telephone_number": "336-591-7001",
            "fax_number": "336-591-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER HEALTH SERVICES OF STOKES COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "MCNULTY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "H1065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Family Medical of Walnut Cove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hannah Jacqueline Munford, CCC-SLP
• North Carolina CVS Pharmacy LLC
• Marla O'Neal, DDS
• October Road, Inc.
• Lydia Spencer Peck, MS, BCBA
• Betty Presnell
• Quad County Group Homes for Emotionally Disturbed Children, Inc.
• Reynolds Care Support, LLC
• James Doyle Richardson, RPH, BS
• Ridge Care Management, Inc.

• Clinic/Center in Walnut Cove, NC
• Providers in Walnut Cove, NC by specialty
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.