Basic Information
| Provider Information | |||||||||
| NPI: | 1306372230 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAMDEN HEALTH AND REHABILITATION, LLC | ||||||||
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| OtherOrganizationName: | CAMDEN HEALTH AND REHABILITATION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MARITHE CT | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274072702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368529700 | ||||||||
| FaxNumber: | 9198829771 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 MARITHE CT | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274072702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368529700 | ||||||||
| FaxNumber: | 9198829771 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2017 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| AuthorizedOfficialLastName: | SPRENGER | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | JOHN | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9196089123 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | NH0624 | NC | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | MC2112491 | 01 | NC | US DEA CONTROLLED SUBSTANCE REGISTRATION NUMBER | OTHER | 3405547 | 05 | NC | MEDICAID | 34D1104341 | 01 | NC | CLIA | OTHER | NC-AA 0000 3834 | 01 | NC | NORTH CAROLINA CONTROLLED SUBSTANCES REGISTRATION NUMBER | OTHER |