# PINEHURST NURSING CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pinehurst Healthcare and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205803137
- **Authorized official:** MR. NICK ELLEDGE (VICE PRESIDENT)
- **Authorized official phone:** (336) 679-8852

## Contact information

- **Practice address:** 300 BLAKE BLVD, PINEHURST, NC 28374-8474
- **Practice address phone:** (910) 295-6158
- **Practice address fax:** (910) 295-6783
- **Mailing address:** PO BOX 5309, PINEHURST, NC 28374-5309
- **Mailing address phone:** (910) 295-6158
- **Mailing address fax:** (910) 295-6783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0294 | NC | Yes |

## Other

- **Enumeration date:** 02/28/2006
- **Last updated:** 09/04/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0091R | BCBS PROVIDER NO | NC |
| 05 | — | 3405370 | — | NC |
| 05 | — | 3406228 | — | NC |