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General NPI Number Information
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NPI Number | 1225248776
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Entity Type | Organization
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Legal Business Name | LUMBER RIVER HEALTHCARE CENTER
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 22401 ANDREW JACKSON HWY
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City | MAXTON
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State | NC
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Zip | 28364-6721
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Country | US
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Telephone | 910-844-8150
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Fax | 910-844-8149
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Provider Business Mailing Address
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Address Line | 22401 ANDREW JACKSON HWY
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City | MAXTON
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State | NC
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Zip | 28364-6721
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Country | US
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Telephone | 910-844-8150
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Fax | 910-844-8149
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NORA HUNT
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Credential |
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Telephone | 910-844-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | NC86727
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License Number State | NC
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