Amethyst LLC
NPI #1255773792 in Wilson, North Carolina
Provider Information
- NPI Number
- 1255773792
- Entity Type
- Organization
- Organization Name
- Amethyst LLC
- Primary Specialty
- Exclusive Provider Organization
- Enumeration Date
- Jul 25, 2013
- Last Updated
- Jul 25, 2013
Practice Location
- Address
- 806 NE ROUNDTREE STREET
- City
- Wilson
- State
- North Carolina
- ZIP Code
- 27893-0806
- Phone
- (252) 230-0631
Authorized Official
- Name
- MS. TAMMY SHERRELL COLEMAN
- Title
- OWNER
- Phone
- (252) 230-0631
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
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