Healthcare Provider Details

I. General information

NPI: 1518952118
Provider Name (Legal Business Name): THE REHABILITATION AND SKILLED NURSING FACILITY AT OAK SUMMIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5680 WINDY HILL DR
WINSTON-SALEM NC
27105-1425
US

IV. Provider business mailing address

5680 WINDY HILL DR
WINSTON-SALEM NC
27105-1425
US

V. Phone/Fax

Practice location:
  • Phone: 336-744-1188
  • Fax:
Mailing address:
  • Phone: 336-744-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License NumberNH0548
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0548
License Number StateNC

VIII. Authorized Official

Name: TAMMY H CHANDLER
Title or Position: CHIEF FINANCIAL OFFICER
Credential: MBA
Phone: 336-776-5057