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General NPI Number Information
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NPI Number | 1689628141
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Entity Type | Organization
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Legal Business Name | SHORELAND HEALTHCARE & RETIREMENT CENTER INC
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 200 FLOWERS PRIDGEN DR
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City | WHITEVILLE
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State | NC
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Zip | 28472
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Country | US
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Telephone | 910-642-4300
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Fax | 910-642-4405
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Provider Business Mailing Address
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Address Line | 2334 SOUTH 41ST ST
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City | WILMINGTON
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State | NC
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Zip | 28403
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Country | US
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Telephone | 910-332-1777
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Fax | 910-815-3114
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Authorized Official
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Title or Position | CFO
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Name | MR. JOE CALCUTT
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Credential |
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Telephone | 910-642-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | NH0510
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License Number State | NC
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