1. Home
  2. Directory
  3. North Carolina
  4. Sophia
  5. Lodging
  6. NPI Profile

COUNTRY CLUB II
NPI 1316087992
Lodging in Sophia, NC

Active since February 06, 2007
4011 OLD COURTHOUSE RD, SOPHIA, NC 27350(336) 674-6293 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Country Club Ii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COUNTRY CLUB II (NPI 1316087992) is a healthcare organization registered as a lodging in Sophia, North Carolina and active in the NPI registry since February 2007. The organization lists Pearlie M. Bullock, Administrator, as its authorized official.

NPPES Registry Identity

NPI1316087992
Entity TypeOrganization
Primary Taxonomy177F00000X
Legal Business NameCOUNTRY CLUB II
Location Address4011 OLD COURTHOUSE RDSophia, NC 27350-8866
Mailing Address1324 Coltrane Mill RdRandleman, NC 27317-8020 · (336) 674-6293
Phone(336) 674-6293
Organization SubpartNo
Authorized OfficialPearlie M. BullockAdministrator · (336) 674-6293
Enumeration DateFebruary 6, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1316087992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLodgingOther Service Providers
Taxonomy Code177F00000X
License✔ Licensed in NC · FCL076031
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
4011 OLD COURTHOUSE RD, Sophia, NC 27350
Open in Google Maps ↗

Other Identifiers 2

MedicaidFCL076031NC
MedicaidMLH076085NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Country Club II's NPI number?

The NPI number for Country Club II is 1316087992. It was assigned to this organization in the NPPES registry on February 6, 2007.

Where is Country Club II located?

Country Club II is located at 4011 Old Courthouse Rd, Sophia, NC 27350. The listed phone number is (336) 674-6293.

What is Country Club II's specialty?

The primary specialty registered for this NPI is Lodging with taxonomy code 177F00000X.

When was this NPI record last updated?

The NPPES record for Country Club II was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.