RV Nursing Home, LLC
Organization Active NPI Skilled Nursing Facility · Rich Square, NC
NPI 1336216779 · NPPES record last updated Jul 16, 2007
Key facts
- NPI
- 1336216779
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NH0045 (NC)
- Legal business name
- RV NURSING HOME, LLC
- Practice address
- 320 North Main Street
Rich Square, NC 27869-0560 - Phone
- (252) 539-4161
- Fax
- (252) 539-4361
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. James T Johnson Jr.
- Title
- Owner
- Phone
- (252) 209-6834
Subparts reporting this organization as parent 2
National Provider Directory
Locations
300 N Main St
Rich Square, NC 27869
Phone (252) 539-3901
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH0045 | NC | Yes |
Addresses
Primary practice location
320 North Main Street
Rich Square, NC 27869-0560
Mailing address
320 North Main Street
P O Box 560
Rich Square, NC 27869-0560
Phone (252) 539-4161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 923433 | Other | NC | FACILITY ID NUMBER |
| 3425356 | Medicaid | NC | |
| 3426020 | Medicaid | NC |
Other names
- Rich Square Health Care Center
Other providers in Rich Square, NC
- Rich Square Operator LLC
- Rooted and Grounded, Inc
- Rural Health Group, Inc.
- RV Assisted Living, LLC
- RV Assisted Living, LLC
- RV Nursing Home, LLC
- RV Nursing Home, LLC
- Justin Shepherd
- Denise Young
All providers in Rich Square, NC · Skilled Nursing Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.