MEDICARE: GRANVILLE HEALTH SYSTEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0081W	OTHER	NC	BCBS PROVIDER #

General Provider Information

NPI Number	:	1265441208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRANVILLE HEALTH SYSTEM

Provider Business Mailing Address
First Line	:	1038 COLLEGE ST
Second Line	:	POB 1006
City	:	OXFORD
State	:	NC
Zip	:	27565-2507
Country	:	US
Telephone Number	:	919-690-3334
Fax Number	:	919-690-0952

Provider Business Practice Location Address
First Line	:	1038 COLLEGE ST
Second Line	:	POB 1006
City	:	OXFORD
State	:	NC
Zip	:	27565-2507
Country	:	US
Telephone Number	:	919-690-3334
Fax Number	:	919-690-0952

Authorized Official
Title or Position	:	CFO
Name	:	JAMIE PURVIS
Credential	:
Telephone Number	:	919-690-3237

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	10/11/2024

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Directions to “GRANVILLE HEALTH SYSTEM ” Practice Location

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