Edenton Prime Time Retirement Village, Llc

LBN: Edenton Prime Time Retirement Village, Llc
Edenton Prime Time Retirement Village, Llc is an health care organization with primary practice located at 106 Mark Dr , Edenton NC 27932-1756. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Edenton Prime Time Retirement Village, Llc can be contacted via phone (252) 482-4491, or through Pierce, Guy S via phone (336) 595-1075.

Contact Information

Primary practice address
106 Mark Dr Edenton NC 27932-1756
Phone: (252) 482-4491
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Pierce, Guy S
Phone: (336) 595-1075

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X HAL-021-005 North Carolina

Profile Details

NPI number 1174608541
LBN Legal business name Edenton Prime Time Retirement Village, Llc
DBA Doing business as
Authorized official Pierce, Guy S
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174608541 NPPES
North Carolina MEDICAID 7804339

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