MEDICARE: LUTHERAN HOME-HICKORY, 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	NH0068	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

General Provider Information

NPI Number	:	1427052067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUTHERAN HOME-HICKORY, INC.

Provider Business Mailing Address
First Line	:	1265 21ST ST NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-2911
Country	:	US
Telephone Number	:	828-328-2006
Fax Number	:	828-327-5012

Provider Business Practice Location Address
First Line	:	1265 21ST ST NE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-2911
Country	:	US
Telephone Number	:	828-328-2006
Fax Number	:	828-327-5012

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. AMBER TRIPLETT MCINTOSH
Credential	:	LNHA
Telephone Number	:	828-328-2006

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	02/04/2026

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