MEDICARE: THE MEADOWS OF GOLDSBORO

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	HAL096021	NC
2	311500000X	Alzheimer Center (Dementia Center)	HAL096021	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	:	1942364591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MEADOWS OF GOLDSBORO

Provider Business Mailing Address
First Line	:	2201 ROYALL AVE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534
Country	:	US
Telephone Number	:	919-735-7684
Fax Number	:	919-735-8552

Provider Business Practice Location Address
First Line	:	2201 ROYALL AVE
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-7409
Country	:	US
Telephone Number	:	919-735-7684
Fax Number	:	919-735-8552

Authorized Official
Title or Position	:	CEO
Name	:	MR. RON BURRELL
Credential	:
Telephone Number	:	252-525-1995

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	09/11/2025

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Directions to “THE MEADOWS OF GOLDSBORO ” Practice Location

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