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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