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NPI 1720305980

NPI 1720305980 : O'BERRY NEURO-MEDICAL TREATMENT CENTER : GOLDSBORO, NC

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General NPI Number Information
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    NPI Number           |    1720305980
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    Entity Type          |    Organization 
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    Legal Business Name  |    O'BERRY NEURO-MEDICAL TREATMENT CENTER 
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Dates
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    Enumeration Date     |    04/28/2010
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    Last Update Date     |    10/17/2024
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Provider Practice Location Address
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    Address Line         |    400 OLD SMITHFIELD RD 
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    City                 |    GOLDSBORO
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    State                |    NC
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    Zip                  |    27530
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    Country              |    US
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    Telephone            |    919-581-4000
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    Fax                  |    919-581-4038
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Provider Business Mailing Address
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    Address Line         |    400 OLD SMITHFIELD RD 
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    City                 |    GOLDSBORO
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    State                |    NC
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    Zip                  |    27530-8464
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    Country              |    US
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    Telephone            |    919-581-4000
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    Fax                  |    919-581-4038
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Authorized Official
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    Title or Position    |    DIVISION DIRECTOR
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    Name                 |     KAREN  BURKES 
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    Credential           |    
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    Telephone            |    919-855-4700
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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       |    
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    License Number State |    NC
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