NPI
Country Club Ii
This page is a copy of the public NPPES file.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2007-02-06
- Last updated
- 2020-08-22
Specialties
Licenses
- License NC
- FCL076031
Location
- Practice location
- 4011 Old Courthouse Rd
- City
- Sophia NC
- Postal code
- 27350-8866
- Phone
- (336) 674-6293
Organization contact
- Name
- PEARLIE BULLOCK
- Title
- Administrator
- Phone
- 3366746293
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.
Nearby
Other NPIs in Sophia, NC. 18 records in the public file.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.
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