Basic Information
| Provider Information | |||||||||
| NPI: | 1720088339 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNC ROCKINGHAM HEALTH CARE, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | UNC ROCKINGHAM REHABILITATION & NURSING CARE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5221 PARAMOUNT PKWY STE 440 | ||||||||
| Address2: | |||||||||
| City: | MORRISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275605491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849711190 | ||||||||
| FaxNumber: | 9849741131 | ||||||||
| Practice Location | |||||||||
| Address1: | 205 E KINGS HWY | ||||||||
| Address2: | |||||||||
| City: | EDEN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272885239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366239711 | ||||||||
| FaxNumber: | 3366236735 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2005 | ||||||||
| LastUpdateDate: | 08/02/2021 | ||||||||
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| AuthorizedOfficialLastName: | SHADOWENS | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 3366278512 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | H0072 | NC | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 3496572 | 05 | NC | MEDICAID | 3405249 | 05 | NC | MEDICAID |