Organization
THE VILLAGE ON CAMPBELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HUGH BLAINE CAMPBELL III (MANAGER)
(910) 332-4508
Entity
Organization
Contact information
Practice address
311 S CAMPBELL ST, BURGAW, NC 28425-5011
(910) 259-6007
(910) 259-6111
Mailing address
311 S CAMPBELL ST, BURGAW, NC 28425-5011
(910) 259-6007
(910) 259-6111
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0461
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NH0461
NC LICENSE
NC
Enumeration date
10/14/2016
Last updated
10/14/2016
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