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Contact Information

AUTUMN CORPORATION
320 N. MAIN ST
RICH SQUARE, NC27869
 Phone: 252-539-4161
 Fax: 252-539-4361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Custodial Care Facility

311Z00000X
Indicates primary specialty

NPI Profile & details for AUTUMN CORPORATION

NPI Number 1750367801
LBN Legal business name AUTUMN CORPORATION
Authorized official SAM MARSH - (VICE PRESIDENT/CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 12/21/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
NC License # HAL066005
NC Medicaid 7803108
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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