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NPI Code Detail

MEDICARE: RIVER NEUSE GROUP, LLC

MEDICARE: RIVER NEUSE GROUP, LLC
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 FacilityNH0344NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20090DOTHERNCBC/BS OF NC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659307395
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER NEUSE GROUP, LLC
Provider Business Mailing Address
First Line : PO BOX 3397
Second Line :
City : NEW BERN
State : NC
Zip : 28564-3397
Country : US
Telephone Number : 252-637-4730
Fax Number : 252-637-0289
Provider Business Practice Location Address
First Line : 2600 OLD CHERRY POINT RD
Second Line :
City : NEW BERN
State : NC
Zip : 28560-6778
Country : US
Telephone Number : 252-637-4730
Fax Number : 252-637-0289
Authorized Official
Title or Position : CFO
Name : GALE BOICE
Credential :
Telephone Number : 252-523-9094
Provider Enumeration Date : 06/24/2006
Last Update Date : 07/16/2021

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