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NPI 1821487786

NPI 1821487786 : BURGAW HEALTH HOLDINGS, LLC : BURGAW, NC

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General NPI Number Information
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    NPI Number           |    1821487786
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    Entity Type          |    Organization 
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    Legal Business Name  |    BURGAW HEALTH HOLDINGS, LLC 
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Dates
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    Enumeration Date     |    01/15/2015
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    Last Update Date     |    10/26/2021
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Provider Practice Location Address
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    Address Line         |    300 W ASHE ST 
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    City                 |    BURGAW
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    State                |    NC
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    Zip                  |    28425-5434
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    Country              |    US
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    Telephone            |    910-259-8070
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2568 
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    City                 |    HICKORY
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    State                |    NC
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    Zip                  |    28603-2568
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    Country              |    US
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    Telephone            |    828-322-5535
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     CHARLES E TREFZGER 
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    Credential           |    
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    Telephone            |    828-322-5535
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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-071-015
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    License Number State |    NC
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Taxonomy #2
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    Taxonomy Code        |    343900000X
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    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    311ZA0620X
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    Taxonomy Name        |    Adult Care Home Facility
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    License Number       |    
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    License Number State |    
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