Active NPI
Rainbow 66 Storehouse Inc.
- Personal Care Attendant
- Laurinburg, NC
National Provider Identifier
1871823500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- HC2475
- 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, 2022
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3418378 | Medicaid | NC | |
| 8302212 | Medicaid | NC | |
| 6601037 | Medicaid | NC | |
| 3409455 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Rainbow 66 Storehouse Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Personal Care Attendant
- Durham, NC
- NPI 1548494966
-
- In Home Supportive Care Agency
- Laurinburg, NC
- NPI 1952637878
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.