PREMIER LIVING AND REHAB CENTER (NPI# 1720085293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720085293 |
| Entity Type | Organization |
| Organization Name | PREMIER LIVING AND REHAB CENTER |
| Practice Address |
106 Cameron St Lake Waccamaw NC 28450-1900 |
| Practice Telephone | 9106463132 |
| Practice Fax Number | 9106464071 |
| Mailing Telephone | 9106463132 |
| Mailing Fax Number | 9106464071 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2011-11-02 |
| Authorized Official Name | MRS. LINDA BENTON PARNELL (ADMINISTRATOR) |
| Authorized Official Telephone | 9106463132 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | NH0246 | NC | Nursing & Custodial Care Facilities |
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
5030990001 | NC | Suppliers |
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
5030990001 | NC | Suppliers |
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | NC | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7804320 | 05 | |
| NC | 3436171 | 05 | |
| NC | 3435185 | 05 |
| Street Address |
106 CAMERON ST |
| City | LAKE WACCAMAW |
| State | NC |
| Zip Code | 28450-1900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649731407 | Kailynn Harrison | Nurse Practitioner | 106 Cameron St, Lake Waccamaw, NC 28450-1900 | 2019-03-26 |
| 1144656414 | Hannah M Fisher | Physical Therapist | 106 Cameron St, Lake Waccamaw, NC 28450-1900 | 2013-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013218312 | Egb Enterjprises | Pharmacy | 108 E Hwy 7476, Lake Waccamaw, NC 28450 | 2010-11-03 |
| 1609996446 | Etcare Home Quality Management, Inc | Assisted Living Facility | 206 Wannish Ave, Lake Waccamaw, NC 28450 | 2007-03-29 |
| 1366593170 | Eugene Glenn Brown Jr. | Pharmacist | 108 E. Highway 74-76, Lake Waccamaw, NC 28450 | 2007-01-16 |
| 1073890489 | Lake Waccamaw Fire & Rescue Squad | Ambulance | 203 Flemington Dr., Lake Waccamaw, NC 28450-0000 | 2011-11-14 |
| 1669555603 | Egb Enterprises Inc | Durable Medical Equipment & Medical Supplies | 108 Old E Hwy 74/76, Lake Waccamaw, NC 28450-0148 | 2006-10-23 |
| 1477795821 | Lake Waccamaw Primary Care, Pllc | Family Medicine | 107 Church St, Lake Waccamaw, NC 28450-1908 | 2009-04-01 |
| 1992019335 | Haven Ministries, Inc. | Psychiatry & Neurology | 107 Church St, Lake Waccamaw, NC 28450-1909 | 2010-07-27 |
| 1528371614 | Haven Ministires, Inc. | Psychiatry & Neurology | 107 Church St, Lake Waccamaw, NC 28450-1909 | 2010-07-19 |
| 1366517872 | Teresa Hopkins | Nurse Practitioner | 107 Church St, Lake Waccamaw, NC 28450-1909 | 2006-11-21 |
| 1013168269 | New Opportunities of Columbus Co. | Day Training, Developmentally Disabled Services | 400 Flemington Dr., Lake Waccamaw, NC 28450-1932 | 2008-10-07 |
| Find all providers in zip 28450 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841617974 | Christopher Rushmeyer | Nursing Facility/Intermediate Care Facility | 1820 Harris Houston Rd, Unit 621411, Charlotte, NC 28262-9253 | 2014-03-26 |
| 1306284674 | Legacy | Nursing Facility/Intermediate Care Facility | 903 W Main Street, Yadkinville, NC 27055 | 2013-06-10 |
| 1194077024 | Skill Creations | Nursing Facility/Intermediate Care Facility | 2101 Royall Ave, Goldsboro, NC 27534-7408 | 2012-10-02 |
| 1093066375 | Sci-east | Nursing Facility/Intermediate Care Facility | 338 Cooper St, Winterville, NC 28590-9507 | 2012-09-26 |
| 1053662437 | Skill Creations of Clinton | Nursing Facility/Intermediate Care Facility | 223 Forest Trail, Clinton, NC 28328-3353 | 2012-09-26 |
| 1821349101 | Sci-duplin House | Nursing Facility/Intermediate Care Facility | 120 Orville Street, Warsaw, NC 28398-2221 | 2012-09-26 |
| 1801147186 | Skill Creations of Kenansville | Nursing Facility/Intermediate Care Facility | 218 S Stokes Street, Kenansville, NC 28349-0001 | 2012-09-26 |
| 1750632030 | Sci-coastal House I and II | Nursing Facility/Intermediate Care Facility | 1974 W Lakeshore Drive, Wilmington, NC 28401-6856 | 2012-09-26 |
| 1760732994 | Sci-triangle House II | Nursing Facility/Intermediate Care Facility | 1523 Tyonek Dr, Durham, NC 27703-5639 | 2012-09-14 |
| 1275883498 | Skill Creations of Kinston | Nursing Facility/Intermediate Care Facility | 901 Doctors Dr, Kinston, NC 28501-1574 | 2012-09-14 |
| Find all providers with the same taxonomy | ||||
| City | LAKE WACCAMAW |
| Zip Code | 28450 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.