OrganizationActive
Country Club II
NPI 1316087992 · Lodging Provider · Sophia, NC
Provider details
- NPI number
- 1316087992
- Entity type
- Organization
- Primary specialty
- Lodging ProviderOther Service Providers
- Organization subpart
- No
- Authorized official
- Pearlie Bullock, Administrator(336) 674-6293
- License
- FCL076031 (NC)
Specialties & taxonomies
Other Service Providers
Practice location
4011 Old Courthouse Rd
Sophia, NC 27350-8866
Phone: (336) 674-6293
Approximate (ZIP-level) locationGet directions
Mailing address
1324 Coltrane Mill Rd
Randleman, NC 27317-8020
Registry dates
- Enumerated
- 2007-02-06
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.