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General NPI Number Information
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NPI Number | 1184712580
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH OF THE PINES, INC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 103 GOSSMAN RD
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-2225
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Country | US
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Telephone | 910-246-1000
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Fax | 910-246-1333
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Provider Business Mailing Address
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Address Line | 100 GOSSMAN RD SUITE B
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-2224
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Country | US
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Telephone | 910-246-3000
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Fax | 910-246-3187
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Authorized Official
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Title or Position | VP REIMBURSEMENT
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Name | PAMELA LATOVICK
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Credential |
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Telephone | 734-343-6628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH0589
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License Number State | NC
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