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TAR RIVER LTC GROUP LLC NPI 1184809279


NPI Information

NPI: 1184809279
Provider Name: TAR RIVER LTC GROUP, LLC

Doing Business As: ROANOKE LANDING NURSING AND REHABILITATION CENTER

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
1084 US HIGHWAY 64 E
PLYMOUTH, NC
ZIP 27962
Phone: (252) 793-2100
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TAR RIVER LTC GROUP, LLC is a nursing facility intermediate care facility in Plymouth, NC. The provider is 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. TAR RIVER LTC GROUP, LLC NPI is 1184809279. The provider is registered as an organization entity type.
The provider Is Doing Business As Roanoke Landing Nursing And Rehabilitation Center.

The provider's business location address is:

1084 US HIGHWAY 64 E
PLYMOUTH, NC
ZIP 27962-215
Phone: (252) 793-2100
Fax: (252) 793-1243

The provider's authorized official is Norwood Randolph Uzzell .
The authorized official title is President and has the following contact phone number (252) 523-9094.

The enumeration date for this NPI number is 1/8/2008 and was last updated on 5/9/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1313M00000XNursing Facility/Intermediate Care FacilityNH0419NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17806621MEDICAIDNORTH CAROLINA
27805286MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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