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General NPI Number Information
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NPI Number | 1821297821
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Entity Type | Organization
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Legal Business Name | H. VANDERWAL INC.
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 401 US 221 S HWY
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City | RUTHERFORDTON
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State | NC
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Zip | 28139
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Country | US
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Telephone | 828-287-4042
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Fax | 828-287-4042
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Provider Business Mailing Address
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Address Line | PO BOX 1351
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City | RUTHERFORDTON
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State | NC
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Zip | 28139-1351
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Country | US
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Telephone | 828-287-4042
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Fax | 828-287-4042
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. HARRY RALPH VANDERWAL
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Credential |
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Telephone | 828-287-4042
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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 | HAL-801-007
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License Number State | NC
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