Organization
ELIZABETHTOWN NURSING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK ELLEDGE (VICE PRESIDENT)
(336) 679-8852
Entity
Organization
Contact information
Practice address
208 MERCER RD, ELIZABETHTOWN, NC 28337-3938
(910) 862-8181
(910) 862-4860
Mailing address
PO BOX 1449, ELIZABETHTOWN, NC 28337-1449
(910) 862-8181
(910) 862-4860
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0328
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00845
BCBS PROVIDER NO
NC
05
—
3406260
—
NC
05
—
3415210
—
NC
Enumeration date
03/01/2006
Last updated
08/22/2020
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