Hertford Place, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-046-016 Issued in NC

Legal business name

HERTFORD PLACE, LLC

Doing business as

Dba Pinewood Manor

Practice address

240 S Early Station Rd
Ahoskie, NC 27910-9378

Phone

(252) 332-4681

NPI assigned

Oct 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Guy S Pierce

Title

Managing Member

Phone

(336) 595-1075

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DBA PINEWOOD MANOR Doing business as

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790860187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1487",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272851487",
            "telephone_number": "336-595-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S EARLY STATION RD",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279109378",
            "telephone_number": "252-332-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERTFORD PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "336-595-1075"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-046-016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804340",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA PINEWOOD MANOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacob Mitchell Heath
• Jorge Enrique Hernandez, M.D.
• Hertford County Public Health Authority
• Hertford County Public Health Authority
• Hertford County Public Health Authority (Hertford-Gates Home Health Agency)
• Stephanie Leigh Hill, MD
• Debbie Lynne Hinton-Thomas, P.A.
• Casey Hoggard, PTA
• Susan T Hoggard
• Natasha Coley Holley, MSW, LCSW

• Assisted Living Facility in Ahoskie, NC
• Providers in Ahoskie, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.