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Contact Information

PREMIER LIVING AND REHAB CENTER
106 CAMERON ST
LAKE WACCAMAW, NC28450-1900
 Phone: 910-646-3132
 Fax: 910-646-4071
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
 

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for PREMIER LIVING AND REHAB CENTER

NPI # 1720085293
LBN Legal business name PREMIER LIVING AND REHAB CENTER
Authorized official LINDA PARNELL - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/30/2005
Last updated 11/02/2011 - About 15 years ago
Identifiers
NC License # 5030990001
NC License # NH0246
NC Medicaid 3435185
NC Medicaid 3436171
NC Medicaid 7804320
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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