MEDICARE: BRITTHAVEN, 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	313M00000X	Nursing Facility/Intermediate Care Facility	NH0436	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	:	1831386267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRITTHAVEN, INC.

Provider Business Mailing Address
First Line	:	3015 ENTERPRISE DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-2116
Country	:	US
Telephone Number	:	910-791-3451
Fax Number	:	910-791-4845

Provider Business Practice Location Address
First Line	:	3015 ENTERPRISE DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-2116
Country	:	US
Telephone Number	:	910-791-3451
Fax Number	:	910-791-4845

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. NORWOOD RANDOLPH UZZELL
Credential	:
Telephone Number	:	252-523-9094

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	10/01/2007

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Directions to “BRITTHAVEN, INC. ” Practice Location

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