Healthcare Provider Details

I. General information

NPI: 1891722187
Provider Name (Legal Business Name): BROSIS MANAGEMENT OF CATAWBA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 4TH STREET SW
CONOVER NC
28613-9679
US

IV. Provider business mailing address

P.O. BOX 1718 920 4TH STREET SW
CONOVER NC
28613-9679
US

V. Phone/Fax

Practice location:
  • Phone: 828-695-8282
  • Fax: 828-695-8218
Mailing address:
  • Phone: 828-695-8282
  • Fax: 828-695-8218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0603
License Number StateNC

VIII. Authorized Official

Name: MR. JOSHUA ANTHONY SHERRILL
Title or Position: OWNER
Credential:
Phone: 828-695-8282