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NPI Code Detail

MEDICARE: STANLY MANOR

MEDICARE: STANLY 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
1314000000XSkilled Nursing FacilityNH0464NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17802196OTHERNCSPECIAL ASSISTANCE

General Provider Information

NPI Number : 1518135193
Entity Type Code : Organization
Provider Name (Legal Business Name) : STANLY MANOR
Provider Business Mailing Address
First Line : 625 BETHANY RD
Second Line :
City : ALBEMARLE
State : NC
Zip : 28001-8523
Country : US
Telephone Number : 704-982-0770
Fax Number : 704-982-1014
Provider Business Practice Location Address
First Line : 625 BETHANY RD
Second Line :
City : ALBEMARLE
State : NC
Zip : 28001-8523
Country : US
Telephone Number : 704-982-0770
Fax Number : 704-982-1014
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. STEPHANIE HERRIN-HUNEYCUTT
Credential :
Telephone Number : 704-982-0770
Provider Enumeration Date : 02/15/2008
Last Update Date : 02/15/2008

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Directions to “STANLY MANOR ” Practice Location

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