Healthcare Provider Details

I. General information

NPI: 1942364591
Provider Name (Legal Business Name): THE MEADOWS OF GOLDSBORO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 ROYALL AVE
GOLDSBORO NC
27534-7409
US

IV. Provider business mailing address

2201 ROYALL AVE
GOLDSBORO NC
27534
US

V. Phone/Fax

Practice location:
  • Phone: 919-735-7684
  • Fax: 919-735-8552
Mailing address:
  • Phone: 919-735-7684
  • Fax: 919-735-8552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberHAL096021
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License NumberHAL096021
License Number StateNC

VIII. Authorized Official

Name: MR. RON BURRELL
Title or Position: CEO
Credential:
Phone: 252-525-1995