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General NPI Number Information
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NPI Number | 1467637553
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Entity Type | Organization
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Legal Business Name | EVEREST LONG TERM CARE, LLC
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 7369 HUNTER HILL RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-7954
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Country | US
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Telephone | 252-443-0867
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Fax | 252-443-2847
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Provider Business Mailing Address
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Address Line | PO BOX 8495
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-1495
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Country | US
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Telephone | 252-443-0867
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Fax | 252-443-2847
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Authorized Official
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Title or Position | PRESIDENT
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Name | NORWOOD RANDOLPH UZZELL
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Credential |
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Telephone | 252-523-9094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NH0437
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License Number State | NC
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