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Organization
CORNELIA NIXON DAVIS, INC.
Active
Organization
CORNELIA NIXON DAVIS, INC.
Active
Other names
Davis Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES ALLEN LONG (EXECUTIVE DIRECTOR)
(910) 686-7195
Entity
Organization
Contact information
Practice address
1011 PORTERS NECK RD, WILMINGTON, NC 28411-9196
(910) 686-7195
(910) 686-7592
Mailing address
1011 PORTERS NECK RD, WILMINGTON, NC 28411-9196
(910) 686-7195
(910) 686-7592
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
—
NULL
314000000X
Skilled Nursing Facility
Primary
NH0097
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00820
BLUE CROSS
NC
05
—
3405160
—
NC
05
—
3406154
—
NC
01
—
7128883
UNITED HEALTHCARE
NC
Enumeration date
06/17/2005
Last updated
10/19/2018
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