Healthcare Provider Details

I. General information

NPI: 1437239167
Provider Name (Legal Business Name): THE LAURELS OF GREENTREE RIDGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 SWEETEN CREEK RD
ASHEVILLE NC
28803-2318
US

IV. Provider business mailing address

70 SWEETEN CREEK RD
ASHEVILLE NC
28803-2318
US

V. Phone/Fax

Practice location:
  • Phone: 828-274-7646
  • Fax: 828-277-4752
Mailing address:
  • Phone: 828-274-7646
  • Fax: 828-277-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberNH 0463
License Number StateNC

VIII. Authorized Official

Name: MR. TIMOTHY PATTON
Title or Position: CFO
Credential:
Phone: 614-794-8800