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Organization

KORNEGAY HEALTHCAREDBA GLENCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIAN ANNE KORNEGAY NURSE (VICE PRESIDENT)
(910) 275-0058
Entity
Organization

Contact information

Practice address
214 LANEFIELD RD, WARSAW, NC 28398-8719
(910) 293-3144
Mailing address
PO BOX 339, KENANSVILLE, NC 28349-0339
(910) 275-0058
(910) 275-0093

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7805079
NC
Enumeration date
03/08/2007
Last updated
08/22/2020
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