MEDICARE: HUNTERSVILLE OAKS NURSING HOME

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1295821130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTERSVILLE OAKS NURSING HOME

Provider Business Mailing Address
First Line	:	12019 VERHOEFF DR
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-9217
Country	:	US
Telephone Number	:	704-512-6438
Fax Number	:	704-512-6485

Provider Business Practice Location Address
First Line	:	13001 OLD STATESVILLE RD
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-8981
Country	:	US
Telephone Number	:	704-875-7400
Fax Number	:	704-874-7490

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. BEVERLY CHOWDRICK
Credential	:	NHA
Telephone Number	:	704-875-7400

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	04/19/2011

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