Organization
BN HEALTHCARE, LLC
Active
Other names
TAR RIVER MANOR
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL PRATER (VICE PRESIDENT OF OPERATIONS)
(336) 633-0055
Entity
Organization
Contact information
Practice address
2578 W 5TH ST, GREENVILLE, NC 27834-7812
(252) 758-7100
(252) 758-1485
Mailing address
2578 W 5TH ST, GREENVILLE, NC 27834-7812
(252) 758-7100
(252) 758-1485
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0446
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0092B
BCBS PROVIDER NUMBER
NC
05
—
3416503
—
NC
05
—
3445181
—
NC
Enumeration date
03/15/2006
Last updated
08/22/2020
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