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Contact Information

GRACEFUL AGING,PC
2732 BARDOLINO DR
FAYETTEVILLE, NC28306-4636
 Phone: 910-868-6477
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GRACEFUL AGING,PC

NPI # 1316259013
LBN Legal business name GRACEFUL AGING,PC
Authorized official SUSANNAH OGUNWO - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/09/2010
Last updated 07/09/2010 - About 16 years ago
Identifiers
NC License # 200601059
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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