Healthcare Provider Details

I. General information

NPI: 1922066612
Provider Name (Legal Business Name): PPRC NURSING HOME, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 WESTCHESTER DR
HIGH POINT NC
27262-7008
US

IV. Provider business mailing address

1901 N CENTENNIAL ST
HIGH POINT NC
27262-7602
US

V. Phone/Fax

Practice location:
  • Phone: 336-884-3444
  • Fax: 336-884-0863
Mailing address:
  • Phone: 336-884-3444
  • Fax: 336-884-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. TOM HIGGINS
Title or Position: PRESIDENT
Credential:
Phone: 338-888-4568