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
—
—
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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