Provider Demographics
NPI:1134425077
Name:KNK CAP SERVICES
Entity type:Organization
Organization Name:KNK CAP SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:252-536-4282
Mailing Address - Street 1:2363 CORNWALLIS RD
Mailing Address - Street 2:
Mailing Address - City:GARYSBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27831-9503
Mailing Address - Country:US
Mailing Address - Phone:252-536-4282
Mailing Address - Fax:252-536-2536
Practice Address - Street 1:2363 CORNWALLIS RD
Practice Address - Street 2:
Practice Address - City:GARYSBURG
Practice Address - State:NC
Practice Address - Zip Code:27831
Practice Address - Country:US
Practice Address - Phone:252-536-4282
Practice Address - Fax:252-536-2536
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K & K HOME HEALTH CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2946251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408321Medicaid