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NPI Code Detail

MEDICARE: WATER OAK MANOR

MEDICARE: WATER OAK MANOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityHAL-025-029NC

General Provider Information

NPI Number : 1225216872
Entity Type Code : Organization
Provider Name (Legal Business Name) : WATER OAK MANOR
Provider Business Mailing Address
First Line : PO BOX 1179
Second Line :
City : PEMBROKE
State : NC
Zip : 28372-1179
Country : US
Telephone Number : 910-521-5550
Fax Number : 910-521-3335
Provider Business Practice Location Address
First Line : 3407 OAKS RD
Second Line :
City : NEW BERN
State : NC
Zip : 28560-2718
Country : US
Telephone Number : 910-521-5550
Fax Number : 910-521-3335
Authorized Official
Title or Position : OWNER
Name : MRS. EDITH WYLENE BIGLER
Credential :
Telephone Number : 910-521-5550
Provider Enumeration Date : 02/06/2008
Last Update Date : 02/06/2008

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Directions to “WATER OAK MANOR ” Practice Location

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