Organization Active NPI

Rainbow 66 Storehouse Inc.

  • Personal Care Attendant
  • Laurinburg, NC
National Provider Identifier
1871823500
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
HC2475 Issued in NC
Legal business name
RAINBOW 66 STOREHOUSE INC.
Practice address
1225 S Caledonia Rd
Laurinburg, NC 28352-4849
Phone
(910) 361-4398
Fax
(910) 361-4510
NPI assigned
Dec 31, 2009
Last updated
Aug 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Authorized official

Name
Mrs. Kimmie Johnson
Title
President
Phone
(910) 361-4398

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X HC2475 NC Primary

Addresses

Primary practice location

1225 S Caledonia Rd
Laurinburg, NC 28352-4849

Mailing address

1225 S Caledonia Rd
Laurinburg, NC 28352-4849
Phone (910) 361-4398

Other identifiers 4

IdentifierTypeStateIssuer
3418378MedicaidNC
8302212MedicaidNC
6601037MedicaidNC
3409455MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Rainbow 66 Storehouse Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1871823500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S CALEDONIA RD",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283524849",
            "telephone_number": "910-361-4398",
            "fax_number": "910-361-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S CALEDONIA RD",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283524849",
            "telephone_number": "910-361-4398",
            "fax_number": "910-361-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW 66 STOREHOUSE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-31",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIMMIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-361-4398",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NC",
            "license": "HC2475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418378",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302212",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6601037",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409455",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurinburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.