MEDICARE: HUNTINGTON HEALTH CARE AND RETIREMENT CENTER 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	314000000X	Skilled Nursing Facility	NH0461	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0086F	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1427024991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTINGTON HEALTH CARE AND RETIREMENT CENTER INC

Provider Business Mailing Address
First Line	:	311 S CAMPBELL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5011
Country	:	US
Telephone Number	:	910-259-6007
Fax Number	:	910-259-6111

Provider Business Practice Location Address
First Line	:	311 S CAMPBELL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5011
Country	:	US
Telephone Number	:	910-259-6007
Fax Number	:	910-259-6111

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JASON PEOPLES
Credential	:
Telephone Number	:	910-259-6007

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	03/28/2012

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