MEDICARE: SUTTON'S RETIREMENT CENTER

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	310400000X	Assisted Living Facility	HAL 096029	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	:	1689886111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUTTON'S RETIREMENT CENTER

Provider Business Mailing Address
First Line	:	4258 HWY 13 NORTH
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534
Country	:	US
Telephone Number	:	919-759-9695
Fax Number	:

Provider Business Practice Location Address
First Line	:	4258 HWY 13 NORTH
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534
Country	:	US
Telephone Number	:	919-759-9695
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	KRISTEN SUTTON TINGEN
Credential	:
Telephone Number	:	919-759-9695

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/22/2020

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Directions to “SUTTON'S RETIREMENT CENTER ” Practice Location

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