Organization
LONGLEAF NEURO MEDICAL TREATMENT CENTER
Active
Organization
LONGLEAF NEURO MEDICAL TREATMENT CENTER
Active
Other names
LONGLEAF NEURO MEDICAL TREATMENT CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BURKES (DIVISION DIRECTOR)
(919) 855-4700
Entity
Organization
Contact information
Practice address
4761 WARD BLVD, WILSON, NC 27893-4359
(252) 399-2109
(252) 399-2136
Mailing address
4761 WARD BLVD, WILSON, NC 27893-4359
(252) 399-2109
(252) 399-2136
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
02460
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2066141
PK
—
05
—
3405192
—
NC
05
—
3406177
—
NC
Enumeration date
01/16/2007
Last updated
03/07/2024
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