MEDICARE: LIFE, INC.

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	315P00000X	Intellectual Disabilities Intermediate Care Facility	MHL-064-020	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	944709	OTHER	NC	STATE FACILITY ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386798163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 446
Second Line	:
City	:	HALIFAX
State	:	NC
Zip	:	27839-0446
Country	:	US
Telephone Number	:	252-972-6975
Fax Number	:	252-212-0135

Provider Business Practice Location Address
First Line	:	1320 GREEN TEE LN
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-9635
Country	:	US
Telephone Number	:	252-972-6975
Fax Number	:	252-212-0135

Authorized Official
Title or Position	:	VP OF BUSINESS OPERATIONS
Name	:	RICHARD LYNN SMITH
Credential	:
Telephone Number	:	919-778-1900

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	12/15/2017

Similar Medicare Providers

1932160553 — SHAUNA LEE PIER DDS
Practice Location Address:

310 CHARLES ST
MOUNT ANGEL, OR
97362-9635

Practice Phone: 503-845-6891
Practice Fax: 503-845-2616

1629039250 — SHAUNA L PIER DDS PC
Practice Location Address:

310 CHARLES ST
MOUNT ANGEL, OR
97362-9635

Practice Phone: 503-845-6891
Practice Fax:

1336393958 — MISS CAITLIN ELIZABETH MCGARVEY LPN
Practice Location Address:

7455 OLD TOWN RD
MOUNT PERRY, OH
43760-9635

Practice Phone: 740-704-2898
Practice Fax:

1437006970 — MRS. ANDREA LYLES DAVIS FNP-BC
Practice Location Address:

91 ENTERPRISE DR
ROCKY MOUNT, NC
27804-9590

Practice Phone: 252-937-0235
Practice Fax:

1588596878 — KESHAWNA EXUM
Practice Location Address:

1750 ACORN RIDGE RD
ROCKY MOUNT, NC
27804-9447

Practice Phone: 919-763-4653
Practice Fax:

1952981763 — BRITTANIE DEANN HAZZARD BIGBY MD
Practice Location Address:

1041 NOELL LN
ROCKY MOUNT, NC
27804-2058

Practice Phone: 252-316-8205
Practice Fax:

Directions to “LIFE, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.