Organization
LOUISBURG NURSING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICK ELLEDGE (VICE PRESIDENT)
(336) 679-8852
Entity
Organization
Contact information
Practice address
202 SMOKETREE WAY, LOUISBURG, NC 27549-2165
(919) 496-2188
(919) 496-3364
Mailing address
PO BOX 629, LOUISBURG, NC 27549-0629
(919) 496-2188
(919) 496-3364
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0264
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088G
BCBS PROVIDER NO
NC
05
—
3405358
—
NC
05
—
3406200
—
NC
Enumeration date
02/27/2006
Last updated
08/22/2020
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