Healthcare Provider Details

I. General information

NPI: 1770329146
Provider Name (Legal Business Name): NHC HEALTHCARE/WAXHAW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2024
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 HOWIE MINE RD
WAXHAW NC
28173-9715
US

IV. Provider business mailing address

PO BOX 1398
MURFREESBORO TN
37133-1398
US

V. Phone/Fax

Practice location:
  • Phone: 704-243-7640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROBERT MICHAEL USSERY
Title or Position: MANAGER OF LLC
Credential:
Phone: 615-890-2020