# LOUISBURG NURSING CENTER, INC.

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

## Provider details

- **NPI number:** 1942276035
- **Authorized official:** MR. NICK ELLEDGE (VICE PRESIDENT)
- **Authorized official phone:** (336) 679-8852

## Contact information

- **Practice address:** 202 SMOKETREE WAY, LOUISBURG, NC 27549-2165
- **Practice address phone:** (919) 496-2188
- **Practice address fax:** (919) 496-3364
- **Mailing address:** PO BOX 629, LOUISBURG, NC 27549-0629
- **Mailing address phone:** (919) 496-2188
- **Mailing address fax:** (919) 496-3364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH0264 | NC | Yes |

## Other

- **Enumeration date:** 02/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0088G | BCBS PROVIDER NO | NC |
| 05 | — | 3405358 | — | NC |
| 05 | — | 3406200 | — | NC |