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NPI Code Detail

MEDICARE: CAROLINA HEALTH CARE CENTER OF CUMBERLAND COUNTY, LP

MEDICARE: CAROLINA HEALTH CARE CENTER OF CUMBERLAND COUNTY, LP
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
1313M00000XNursing Facility/Intermediate Care FacilityNH0593NC
2314000000XSkilled Nursing FacilityNH0593NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902990153
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINA HEALTH CARE CENTER OF CUMBERLAND COUNTY, LP
Provider Business Mailing Address
First Line : 2917 PENN FOREST BLVD
Second Line :
City : ROANOKE
State : VA
Zip : 24018-4374
Country : US
Telephone Number : 540-989-3618
Fax Number : 540-774-9443
Provider Business Practice Location Address
First Line : 4600 CUMBERLAND RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28306-2412
Country : US
Telephone Number : 910-429-1690
Fax Number : 910-429-1710
Authorized Official
Title or Position : CFO, MFA INC. GENERAL PARTNER
Name : MR. CLAUDE NOVEL MARTIN III
Credential :
Telephone Number : 540-776-7526
Provider Enumeration Date : 10/03/2006
Last Update Date : 05/20/2010

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Directions to “CAROLINA HEALTH CARE CENTER OF CUMBERLAND COUNTY, LP ” Practice Location

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