NPIMap

Organization Active NPI

Glencare of Bladenboro

  • Assisted Living Facility
  • Bladenboro, NC
National Provider Identifier
1366624371
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GLENCARE OF BLADENBORO
Practice address
714 East Bladen Street
Bladenboro, NC 28320
Phone
(910) 863-4500
Fax
(910) 863-3142
NPI assigned
Nov 30, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Marian Anne Kornegay
Title
Vice President
Phone
(910) 275-0058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

714 East Bladen Street
Bladenboro, NC 28320

Mailing address

PO Box 339
Kenansville, NC 28349-0339
Phone (910) 275-0058

National Provider Directory

National Provider Directory
Tax ID family
Glencare Assisted Living Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1366624371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283490339",
            "telephone_number": "910-275-0058",
            "fax_number": "910-275-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 EAST BLADEN STREET",
            "city": "BLADENBORO",
            "state": "NC",
            "postal_code": "28320",
            "telephone_number": "910-863-4500",
            "fax_number": "910-863-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENCARE OF BLADENBORO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "KORNEGAY",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "910-275-0058",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bladenboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.