# ELIZABETHTOWN NURSING CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073580957
- **Authorized official:** MR. NICK ELLEDGE (VICE PRESIDENT)
- **Authorized official phone:** (336) 679-8852

## Contact information

- **Practice address:** 208 MERCER RD, ELIZABETHTOWN, NC 28337-3938
- **Practice address phone:** (910) 862-8181
- **Practice address fax:** (910) 862-4860
- **Mailing address:** PO BOX 1449, ELIZABETHTOWN, NC 28337-1449
- **Mailing address phone:** (910) 862-8181
- **Mailing address fax:** (910) 862-4860

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0328 | NC | Yes |

## Other

- **Enumeration date:** 03/01/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00845 | BCBS PROVIDER NO | NC |
| 05 | — | 3406260 | — | NC |
| 05 | — | 3415210 | — | NC |